Abstract IA-48: A brief overview of lung and colorectal cancer disparities in American Indian and Alaska Native populations

Abstract

Abstract Lung cancer and colorectal cancer (CRC) are leading causes of cancer morbidity and mortality among US American Indian and Alaska Native (AI/AN) men and women. For most AI/AN communities, disparities in these cancers occur compared to their non-Hispanic White (NHW) counterparts. This presentation provides a brief overview of the epidemiology of lung and colorectal cancers among AI/AN, and serves as background for talks regarding the impact of revised eligibility criteria for implementing screening programs among AI/AN. In recent years, lung cancer incidence rates among AI/AN persons were 12% higher than rates among NHW in counties with relatively high proportions of AI/AN residents. By region, rates were 17% to 3 times higher in AI/AN than NHW in Pacific Coast, Alaska, and Northern and Southern Plains, in contrast to the Southwest and Eastern US where AI/AN rates were 35% lower. While lung cancer incidence is decreasing overall in both populations, the rate of decrease is slower for AI/AN. Generally, lung cancer occurs at younger ages and at more advanced stages for AI/AN compared with NHW, and AI/AN persons with lung cancer have worse survival. Little is known about the experience of lung cancer screening (LCS) in health care systems that serve AI/AN communities. LCS has not been a mandatory reporting measure for the Indian Health Service. Models of expanded eligibility for LCS suggest that AI/AN will have a higher relative increase in eligible persons compared with NHW, but information on implementation is scarce. Disparities in CRC are also notable among AI/AN. In recent years, incidence rates among AI/AN were 41% higher than among NHW in counties with relatively high proportions of AI/AN residents. CRC incidence rates also vary regionally, but AI/AN in general had higher CRC incidence rates than did NHW. CRC incidence rates have been decreasing overall among both AI/AN and NHW populations, but at a slower pace for AI/AN. Notably, CRC incidence increased among AI/AN in the Southwest. CRC incidence rates have also increased among persons younger than 50 years for both AI/AN and NHW, but more than 1 in 7 CRC cases among AI/AN were diagnosed at ages younger than 50 years, compared with less than 1 in 10 among NHW. AI/AN were more likely to have late-stage diagnoses than were NHW, and AI/AN men had the worst survival than men in other racial groups. Factors encountered in implementing programs to improve lung and CRC screening among AI/AN health care systems will be discussed follow this presentation. Citation Format: Dorothy A. Rhoades. A brief overview of lung and colorectal cancer disparities in American Indian and Alaska Native populations [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr IA-48.