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. 2023 Jul:83:78-86.e2.
doi: 10.1016/j.annepidem.2023.04.016. Epub 2023 Apr 28.

Incidence of selected cancers in Non-Hispanic American Indian and Alaska Native adolescent and young adult populations, 1999-2019

Stephanie C Melkonian  1 , Nathania Said  2 , Hannah K Weir  3 , Melissa A Jim  4 , David A Siegel  3
Affiliations

Incidence of selected cancers in Non-Hispanic American Indian and Alaska Native adolescent and young adult populations, 1999-2019

Stephanie C Melkonian et al. Ann Epidemiol. 2023 Jul.

Abstract

Purpose: Studies have highlighted geographic variation in cancer incidence rates among American Indian and Alaska Native (AI/AN) populations. This is the first study to comprehensively evaluate incidence rates and trends among non-Hispanic AI/AN (NH-AI/AN) adolescents and young adults (AYAs) ages 15-39 years.

Methods: Using the United States Cancer Statistics AI/AN Incidence Analytic Database, we identified all malignant cancer cases for NH-AI/AN AYA populations for the years 1999-2019. We calculated age-adjusted incidence rates (per 100,000) for NH-AI/AN populations overall, by region, and by age group. We calculated the total percent change in the incidence of leading AYA cancers between 1999 and 2019, and trends by region and cancer type using Joinpoint analysis.

Results: Testicular (13.6) and breast (19.0) cancers had the highest incidence of all AYA cancers in NH-AI/AN males and females, respectively. Overall AYA cancer rates increased by 1.4% in NH-AI/AN males and 1.8% in NH-AI/AN females annually between 1999 and 2019. Increases were observed by age group and geographic region.

Conclusions: This study describes regional differences in incidence rates of AYA cancers among NH-AI/AN populations. This data can help inform resource and cancer control priorities and strategies to reduce cancer risk and enhance access to quality diagnostic and treatment services for this population.

Keywords: Adolescents and young adults; Alaska Native; American Indian; Cancer incidence; Health disparity; Trends.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1.
Fig. 1.. Annual age-adjusted incidence ratesa and trend lines for all AYAb cancer sites in NH-AI/ANc populations, by sex, PRCDA counties, U.S., 1999–2019.
Source: National Program of Cancer Registries and Surveillance, Epidemiology, and End Results SEER*Stat Database: U.S. Cancer Statistics American Indian and Alaska Native Incidence Analytic Database—1999–2019. United States Department of Health and Human Services—Centers for Disease Control and Prevention. Released June 2022—based on the 2021 submission. aRates are per 100,000 persons and are age-adjusted to the 2000 U.S. standard population by use of 5-year age groups (15–19, 20–24, 25–29, 30–34, 35–39). bAYA refers to adolescents and young adults (15–39 years of age). AYA cancers identified using classification scheme proposed by R.D. Barr and colleagues. Scheme described at https://seer.cancer.gov/ayarecode/. Present analysis includes malignant cancers only. cAI/AN race is reported by NPCR and SEER registries or through linkage with the IHS patient registration database. Includes only AI/AN of non-Hispanic origin. dAAPC refers annual average percentage change and is calculated using Joinpoint Regression. P-value < .05 indicates a significant trend.
Fig. 2.
Fig. 2.. Annual age-adjusted incidence ratesa and trend lines for all AYAb cancer sites in NH-AI/ANc,d population, by sex and age group, PRCDA, U.S., 1999–2019.
Source: National Program of Cancer Registries and Surveillance, Epidemiology, and End Results SEER*Stat Database: U.S. Cancer Statistics American Indian and Alaska Native Incidence Analytic Database—1999–2019. United States Department of Health and Human Services—Centers for Disease Control and Prevention. Released June 2022—based on the 2021 submission. aRates are per 100,000 persons and are age-adjusted to the 2000 U.S. standard population by use of 5-year age groups (15–19, 20–24, 25–29, 30–34, 35–39). bAYA refers to adolescents and young adults (15–39 years of age). AYA cancers identified using classification scheme proposed by R.D. Barr and colleagues. Scheme described at https://seer.cancer.gov/ayarecode/. Present analysis includes malignant cancers only. cAI/AN race is reported by NPCR and SEER registries or through linkage with the IHS patient registration database. Includes only AI/AN of non-Hispanic origin. dAAPC refers annual average percentage change and is calculated using Joinpoint Regression. P-value < .05 indicates a significant trend.
Fig. 3.
Fig. 3.. Change in ratesa in selected AYAb cancers in NH-AI/ANc populations, by sex, PRCDA Counties, U.S., 1999–2019.
Source: National Program of Cancer Registries and Surveillance, Epidemiology, and End Results SEER*Stat Database: U.S. Cancer Statistics American Indian and Alaska Native Incidence Analytic Database—1999–2019. United States Department of Health and Human Services—Centers for Disease Control and Prevention. Released June 2022—based on the 2021 submission. aRates are per 100,000 persons and are age-adjusted to the 2000 U.S. standard population by use of 5-year age groups (15–19, 20–24, 25–29, 30–34, 35–39). The change in rates was calculated as the total percent change from the 5-year rate for 1999–2004 to the 5-year rate for 2015–2019. bAYA refers to adolescents and young adults (15–39 years of age). AYA cancers identified using classification scheme proposed by R.D. Barr and colleagues. Scheme described at https://seer.cancer.gov/ayarecode/. Present analysis includes malignant cancers only. Cancers selected based on top five cancers in males (A) and females (B). Kidney is excluded due to small counts for males. cAI/AN race is reported by NPCR and SEER registries or through linkage with the IHS patient registration database. Includes only AI/AN of non-Hispanic origin.
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