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Introduction to the supplement on cancer in the American Indian and Alaska Native populations in the United States

Division of Epidemiology and Disease Prevention, Indian Health Service, Albuquerque, New Mexico, USA.
Cancer (Impact Factor: 4.9). 09/2008; 113(5 Suppl):1113-6. DOI: 10.1002/cncr.23729
Source: PubMed

ABSTRACT The collection of papers in this Supplement combines cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results program, enhanced by record linkages and geographic factors, to provide a comprehensive description of the cancer burden in the American Indian/Alaska Native population in the United States. Cancer incidence rates among this population varied widely, sometimes more than 5-fold, by geographic region.

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    • "In the last half of the 20th century, cancer has become a leading cause of death for American Indians over age 45 (Kaur & Hampton, 2008) and the 3rd most frequent reason for hospital stays (Steele et al., 2008). Despite some positive changes in cancer rates in recent years, disparities between American Indians and Non-Hispanic Whites persist in healthcare access, health status indicators, cancer risk factors, and use of cancer screening tests (Cobb et al., 2008). Further, cancer is responsible for more deaths among American Indians than health priorities that receive more attention in tribal communities, such as substance abuse or diabetes. "
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    ABSTRACT: In response to a Request for Proposals from the National Cancer Institute (NCI), the Inter Tribal Council of Arizona (ITCA) along with health care partners from the Phoenix Indian medical Center (PIMC) and academic partners from the Arizona Cancer Center (ACC) at the University of Arizona (UA), and the University of Nevada Las Vegas (UNLV) established a Community Network Program entitled the Southwest American Indian Collaborative Network (SAICN). The ultimate goal of the SAICN project was to "eliminate cancer health disparities by closing the gap between the health needs of the community and cancer prevention and control made possible by a responsive health delivery and research system. " At the close of the 5-year funding period for the SAICN project, a RE-AIM framework provided an important evaluative tool for identifying areas of potential long-term impact.
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    ABSTRACT: Graduation date: 2010 American Indians and Alaska Natives have disproportionately high rates of diabetes, and it is not known if perceived medical discrimination is associated with diabetes health measures and poorer health for this population. This study examined the effect of perceived medical discrimination (PMD) in American Indian women on health care decisions, cancer screening, diabetes services, and diabetes control. The study investigated the performance of well-known PMD measures, reported prevalence and correlates of PMD, association of PMD with the receipt of cancer screening, standard Indian Health Service (IHS) diabetes care services and diabetes control measures. Survey and medical records data were collected from 270 AI women whose primary medical care is from Northwest Indian health care facilities. Medical data on receipt of 13 IHS minimum standards of care and 3 clinical values were collected from the Resource Patient Management System and used to assess diabetes control. Race-PMD was assessed using a validated multi-item scale. Logistic regression was performed using Generalized Estimating Equations. Three PMD scales tested in our study had high internal reliability (α=0.85, 0.90,and 0.94). Prevalence of PMD was 4 to 6.5 times greater than that previously reported. Race-based PMD was significantly associated with negative health care decisions, including postponing needed medical care, delaying or foregoing follow-up care,avoiding getting care at the facility, and not following medical advice. Race-based PMD was significantly associated with AI women not being up-to-date on clinical breast exams (OR 2.56), pap tests (OR 2.67) and mammography (OR 1.61). Respondents reporting race-PMD were significantly more likely to not be current on IHS standards of diabetes care for annual dental exams and testing for creatinine, total cholesterol, and HDL, and had a 49% increased likelihood of receiving fewer standard diabetes care services (≤6). The study found no significant association between race-PMD and diabetes control measures. Race-PMD may be a barrier to medical care utilization by influencing AI womens' health care decisions to postpone and delay needed medical care. These findings have implications for health-care centered efforts and policies to address and eliminate the health disparities of diabetes, as well as cancer, within this population.
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    Preventing chronic disease 10/2009; 6(4):A133. · 1.96 Impact Factor
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