Breast cancer incidence among American Indian and Alaska Native women: US, 1999-2004

Cancer. 2008 Sep 1;113(5 Suppl):1191-202. doi: 10.1002/cncr.23725.


Background: Breast cancer is a leading cause of cancer morbidity and mortality among American Indian and Alaska Native (AI/AN) women. Although published studies have suggested that breast cancer rates among AI/AN women are lower than those among other racial and ethnic populations, accurate determinations of the breast cancer burden have been hampered by misclassification of AI/AN race.

Methods: Cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age-adjusted rates for the diagnosis years 1999 through 2004. Several steps were taken to reduce the misclassification of AI/AN race: linking cases to Indian Health Service (IHS) patient services database, restricting analyses to Contract Health Service Delivery Area counties, and stratifying results by IHS region.

Results: Breast cancer incidence rates among AI/AN women varied nearly 3-fold across IHS regions. The highest rates were in Alaska (134.8) and the Plains (Northern, 115.9; Southern, 115.7), and the lowest rates were in the Southwest (50.8). The rate in Alaska was similar to the rate among non-Hispanic white (NHW) women in Alaska. Overall, AI/AN women had lower rates of breast cancer than NHW women, but AI/AN women were more likely to be diagnosed with late-stage disease.

Conclusions: To the authors' knowledge, this report provides the most comprehensive breast cancer incidence data for AI/AN women to date. The wide regional variation indicates an important need for etiologic and health services research, and the large percentage of AI/AN women with late-stage disease demands innovative approaches for increasing access to screening.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenocarcinoma / ethnology*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alaska / epidemiology
  • Breast Neoplasms / ethnology*
  • Child
  • Child, Preschool
  • Continental Population Groups / statistics & numerical data
  • Female
  • Humans
  • Incidence
  • Indians, North American / statistics & numerical data*
  • Infant
  • Infant, Newborn
  • Inuits / statistics & numerical data*
  • Middle Aged
  • Neoplasm Invasiveness
  • Population Surveillance
  • Registries
  • United States / epidemiology