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American Indians, Alaskan Natives experienced shorter cancer survival, even with equal access to care
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Cancer survivors of American Indian or Alaskan Native descent demonstrated poorer rates of 5- and 10-year cancer survival than non-Hispanic whites even when they had equal access to health care, according to study results presented at the American Association for Cancer Research Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved in San Antonio.
Marc A. Emerson, MPH, cancer research training award fellow in the division of cancer control and population sciences at the NCI, and colleagues used Kaiser Permanente Northern California electronic health records to collect data on 1,022 American Indians and Alaskan Natives diagnosed with primary invasive cancer between 1997 and 2012.
Researchers compared outcomes for those patients with outcomes of 139,725 non-Hispanic white patients diagnosed with primary invasive cancer during the same period.
“Our study focused on American Indian and Alaskan Natives who live largely in urban areas, a population often hidden to researchers,” Emerson said in a press release.
The five most common cancers diagnosed among American Indians and Alaskan Natives were prostate cancer (16.4%), breast cancer (16.4%), lung cancer (13.3%), colorectal cancer (12.5%) and non-Hodgkin’s lymphoma (4%). The most common cancers diagnosed among non-Hispanic whites were prostate cancer (17.3%), breast cancer (16.8%), lung cancer (11.7%), colorectal cancer (9.3%) and melanoma (6.6%).
Overall, results showed rates of 5-year OS (58.2% vs. 51.9%; P<.001) and 10-year OS (43.8% vs. 37.4%; P<.001) were significantly higher among non-Hispanic whites than patients of American Indian or Alaskan Native descent.
When researchers examined outcomes by cancer type, they determined both 5-year and 10-year OS were consistently higher among non-Hispanic white patients than American Indians and Alaskan Natives; however, the difference was only statistically significant among those diagnosed with breast cancer.
“The American Indian and Alaskan Native population experiences some of the greatest disparities in health and health outcomes, yet this remains an understudied area of research,” Emerson said. “Future research should focus on factors other than health care access that may be driving disparity in the cancer outcomes observed.”
American Indians and Alaskan Natives with any cancer had a significantly higher rates of comorbidities (P<.003) compared with non-Hispanic whites. Specifically, American Indians and Alaskan natives had higher rates of chronic pulmonary disease (25.5% vs. 21.4%), diabetes (18.7% vs. 14.3%) and congestive heart disease (7% vs. 6%).
“In future analyses, we will examine the extent to which prevalence of comorbidities and other factors may account for the survival differences observed,” Emerson said.
For more information:
Emerson MA. Abstract #B39. Presented at: American Association for Cancer Research Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov. 9-12, 2014; San Antonio.
Disclosure: The study was funded by the NCI. The researchers report no relevant financial disclosures.