Mortality Up for Some Cancers in Urban-Dwelling Native Americans
Urban American Indians and Alaskan Natives with cancer have significantly higher comorbidity burden
THURSDAY, Nov. 30, 2017 (HealthDay News) -- Urban American Indians and Alaskan Natives (AIAN) with cancer have a significantly higher comorbidity burden, and have higher mortality for some cancers, according to a study published online Nov. 29 in Cancer Research.
Marc A. Emerson, M.P.H., from the National Cancer Institute in Bethesda, Md., and colleagues compared all-cause and prostate, breast, lung, and colorectal cancer-specific mortality among 582 AIAN and 82,696 non-Hispanic white (NHW) individuals diagnosed with primary invasive breast, prostate, lung, or colorectal cancer. Data were extracted on sociodemographic, comorbidity, tumor, clinical, and treatment characteristics.
The researchers found that the comorbidity burden was significantly higher for AIAN than NHW (P < 0.05). All-cause mortality and cancer-specific mortality were significantly higher for AIAN than NHW patients with breast or prostate cancer (hazard ratios, 1.47 and 1.87, respectively), but not those with lung or colorectal cancer, after adjustment for patient, disease characteristics, and Charlson comorbidity scores. Mortality was higher for AIAN than NHW with some cancers despite almost equal access to preventive services and cancer care in this setting; furthermore, a greater proportion of AIAN cancer patients had multiple comorbid conditions.
"This study provides severely needed information on the cancer experience of the 71 percent of AIANs 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," the authors write.