Disparities in prostate, lung, breast and colorectal cancer survival and comorbidity status among urban American Indians and Alaskan Natives

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Authors: Marc A. Emerson et al.

Publication Year: 2017

Last Updated:

Journal: Cancer Research

Keywords: Cancer; Health Disparities; Survival

 

Short Abstract: Cancer is the second leading cause of death among American Indians and Alaskan Natives (AIAN); although cancer survival information in this population is limited, particularly among urban AIAN.

 

Abstract: Cancer is the second leading cause of death among American Indians and Alaskan Natives (AIAN); although cancer survival information in this population is limited, particularly among urban AIAN. In this retrospective cohort study, we compared all-cause and prostate, breast, lung, and colorectal cancer-specific mortality among AIAN (n=582) and non-Hispanic Whites (NHW) (n=82,696) enrollees of Kaiser Permanente Northern California (KPNC) diagnosed with primary invasive breast, prostate, lung, or colorectal cancer from 1997–2015. Tumor registry and other electronic health records provided information on sociodemographic, comorbidities, tumor, clinical, and treatment characteristics. Cox regression models were used to estimate adjusted survival curves and hazard ratios (HR) with 95% confidence intervals (CI). AIAN had a significantly higher comorbidity burden compared to NHW (p < 0.05). When adjusting for patient, disease characteristics and Charlson comorbidity scores, all-cause mortality and cancer-specific mortality were significantly higher for AIAN than NHW patients with breast cancer (HR= 1.47, 95% CI: 1.13, 1.92) or with prostate cancer (HR = 1.87, 95% CI: 1.14, 3.06) but not for AIAN patients with lung and colorectal cancer. Despite approximately equal access to preventive services and cancer care in this setting, we found higher mortality for AIAN than NHW with some cancers, and a greater proportion of AIAN cancer patients with multiple comorbid conditions. This study provides severely needed information on the cancer experience of the 71% of American Indians/Alaskan Natives who live in urban areas and access cancer care outside of the Indian Health Services, from which the vast majority of AIAN cancer information comes.

 

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728425/

Type of Resource: Peer-reviewed scientific article