Screening Prevalence and Incidence of Colorectal Cancer Among American Indian/Alaskan Natives in the Indian Health Service

• Main Authors: Day, Lukejohn W, Espey, David K, Madden, Erin, Segal, Mark, Terdiman, Jonathan P
• Format: Article in Journal/Newspaper
• Language: unknown
• Published: eScholarship, University of California 2011
• Subjects: Biomedical and Clinical Sciences; Clinical Sciences; Digestive Diseases; Cancer; American Indian or Alaska Native; Prevention; Arctic; Rural Health; Health Services; Clinical Research; Colo-Rectal Cancer; Detection; screening and diagnosis; 4.4 Population screening; Good Health and Well Being; Aged; Alaska; Cohort Studies; Colorectal Neoplasms; Early Detection of Cancer; Female; Humans; Incidence; Indians; North American; Inuit; Male; Middle Aged; Prevalence; Retrospective Studies; United States; Screening; Colonoscopy; Health disparity; Gastroenterology & Hepatology; Indian; Pacific; inuit
• Online Access: https://escholarship.org/uc/item/3rj6s467

BackgroundStudies on colorectal cancer (CRC) screening and incidence among American Indian/Alaska Natives (AI/AN) are few.AimsOur aim was to determine CRC screening prevalence and to calculate CRC incidence among AI/AN receiving care within the Indian Health Service (IHS).MethodsA retrospective cohort study of AI/AN who utilized IHS from 1996 to 2004. AI/AN who were average-risk for CRC and received primary care within IHS were identified by searching the IHS Resource Patient Management System for selected ICD-9/CPT codes (n=142,051). CRC screening prevalence was calculated and predictors of screening were determined for this group. CRC incidence rates were ascertained for the entire AI/AN population ages 50-80 who received IHS medical care between 1996 and 2004 (n=283,717).ResultsCRC screening was performed in 4.0% of average-risk AI/AN. CRC screening was more common among women than men (RR=1.6, 95% CI 1.4-1.7) and among AI/AN living in the Alaska region compared to the Pacific Coast region (RR=2.5, 95% CI 2.2-2.8) while patients living in the Northern Plains (RR=0.4, 95% CI 0.3-0.4) were less likely to have been screened. CRC screening was less common among patients with a greater number of primary care visits. The age-adjusted CRC incidence among AI/AN ages 50-80 was 227 cancers per 100,000 person-years.ConclusionsCRC was common among AI/AN receiving medical care within IHS. However, CRC screening prevalence was far lower than has been reported for the U.S. population.