TABLE 3—
Colorectal Cancer Incidence by Indian Health Service Region, Stage at Diagnosis, and Gender for American Indian/Alaska Native and White Persons: CHSDA Counties, United States, 2005–2009
| AI/AN | White | |||||||
| IHS Region/Gender | Stage | Cases, No. (%) | Rate | Late/Early Stage RR (95% CI) | Cases, No. (%) | Rate | Late/Early Stage RR (95% CI) | AI/AN:White RRa |
| Northern Plains | ||||||||
| Both genders | Early | 175 (37.80) | 23.9 | 7638 (44.66) | 16.9 | 1.41 | ||
| Late | 288 (62.20) | 36.4 | 1.52* (1.23, 1.88) | 9465 (55.34) | 21.0 | 1.25* (1.21, 1.28) | 1.73 | |
| Men | Early | 91 (36.11) | 27.3 | 3954 (45.40) | 19.4 | 1.41 | ||
| Late | 161 (63.89) | 43.3 | 1.59* (1.18, 2.15) | 4755 (54.60) | 23.2 | 1.20* (1.15, 1.25) | 1.87 | |
| Women | Early | 84 (39.81) | 21.1 | 3684 (43.89) | 14.7 | 1.44 | ||
| Late | 127 (60.19) | 30.3 | 1.44* (1.06, 1.95) | 4710 (56.11) | 19.1 | 1.30* (1.24, 1.36) | 1.59 | |
| Alaska | ||||||||
| Both genders | Early | 115 (37.10) | 32.3 | 329 (45.63) | 18.0 | 1.79 | ||
| Late | 195 (62.90) | 55.8 | 1.73* (1.35, 2.23) | 392 (54.37) | 20.0 | 1.11 (0.95, 1.31) | 2.79 | |
| Men | Early | 64 (40.25) | 39.4 | 173 (42.30) | 18.0 | 2.19 | ||
| Late | 95 (59.75) | 61.0 | 1.55* (1.08, 2.24) | 236 (57.70) | 23.8 | 1.32* (1.05, 1.67) | 2.56 | |
| Women | Early | 51 (33.77) | 26.5 | 156 (50.00) | 18.0 | 1.47 | ||
| Late | 100 (66.23) | 53.5 | 2.02* (1.41, 2.92) | 156 (50.00) | 16.3 | 0.91 (0.71, 1.15) | 3.28 | |
| Southern Plains | ||||||||
| Both genders | Early | 289 (40.36) | 24.4 | 3259 (43.95) | 17.9 | 1.36 | ||
| Late | 427 (59.64) | 34.7 | 1.42* (1.21, 1.67) | 4157 (56.05) | 23.0 | 1.28* (1.22, 1.34) | 1.51 | |
| Men | Early | 129 (37.61) | 24.7 | 1704 (43.96) | 20.9 | 1.18 | ||
| Late | 214 (62.39) | 38.3 | 1.55* (1.22, 1.99) | 2172 (56.04) | 26.6 | 1.27* (1.19, 1.36) | 1.44 | |
| Women | Early | 160 (42.90) | 24.1 | 1555 (43.93) | 15.4 | 1.56 | ||
| Late | 213 (57.10) | 32.0 | 1.33* (1.07, 1.65) | 1985 (56.07) | 20.0 | 1.29* (1.21, 1.38) | 1.60 | |
| Pacific Coast | ||||||||
| Both Genders | Early | 162 (35.37) | 16.7 | 14 411 (41.38) | 16.7 | 1.00 | ||
| Late | 296 (64.63) | 28.7 | 1.72* (1.39, 2.13) | 20 415 (58.62) | 23.7 | 1.42* (1.39, 1.45) | 1.21 | |
| Men | Early | 88 (36.67) | 18.9 | 7562 (41.95) | 19.3 | 0.98 | ||
| Late | 152 (63.33) | 30.0 | 1.58* (1.17, 2.15) | 10 464 (58.05) | 26.6 | 1.38* (1.34, 1.43) | 1.13 | |
| Women | Early | 74 (33.94) | 14.6 | 6849 (40.77) | 14.5 | 1.01 | ||
| Late | 144 (66.06) | 27.3 | 1.87* (1.39, 2.55) | 9951 (59.23) | 21.1 | 1.46* (1.41, 1.51) | 1.29 | |
| East | ||||||||
| Both genders | Early | 63 (45.32) | 14.3 | 17 039 (45.14) | 19.0 | 0.75 | ||
| Late | 76 (54.68) | 18.9 | 1.31 (0.91, 1.91) | 20 707 (54.86) | 23.2 | 1.22* (1.20, 1.25) | 0.81 | |
| Men | Early | 39 (57.35) | 18.0 | 8848 (45.83) | 22.4 | 0.80 | ||
| Late | 29 (42.65) | 15.2 | 0.84 (0.47, 1.45) | 10 459 (54.17) | 26.6 | 1.19* (1.16, 1.22) | 0.57 | |
| Women | Early | 24 (33.80) | 10.5 | 8191 (44.42) | 16.3 | 0.64 | ||
| Late | 47 (66.20) | 21.6 | 2.06* (1.21, 3.62) | 10 248 (55.58) | 20.4 | 1.26* (1.22, 1.30) | 1.06 | |
| Southwest | ||||||||
| Both genders | Early | 194 (42.73) | 11.8 | 6546 (43.96) | 15.1 | 0.78 | ||
| Late | 260 (57.27) | 15.1 | 1.28* (1.05, 1.56) | 8346 (56.04) | 19.4 | 1.29* (1.24, 1.33) | 0.78 | |
| Men | Early | 107 (45.15) | 14.8 | 3510 (44.48) | 17.2 | 0.86 | ||
| Late | 130 (54.85) | 16.0 | 1.08 (0.82, 1.44) | 4382 (55.52) | 21.7 | 1.26* (1.20, 1.32) | 0.74 | |
| Women | Early | 87 (40.09) | 9.5 | 3036 (43.37) | 13.1 | 0.73 | ||
| Late | 130 (59.91) | 14.1 | 1.49* (1.12, 1.99) | 3964 (56.63) | 17.3 | 1.32* (1.26, 1.38) | 0.82 | |
| All regions | ||||||||
| Both genders | Early | 998 (39.29) | 18.8 | 49 222 (43.67) | 17.3 | 1.09 | ||
| Late | 1542 (60.71) | 28.1 | 1.49* (1.37, 1.62) | 63 482 (56.33) | 22.4 | 1.30* (1.28, 1.31) | 1.25 | |
| Men | Early | 518 (39.88) | 21.6 | 25 751 (44.23) | 20.0 | 1.08 | ||
| Late | 781 (60.12) | 30.5 | 1.41* (1.25, 1.60) | 32 468 (55.77) | 25.3 | 1.26* (1.24, 1.28) | 1.21 | |
| Women | Early | 480 (38.68) | 16.5 | 23 471 (43.08) | 15.0 | 1.10 | ||
| Late | 761 (61.32) | 25.9 | 1.57* (1.39, 1.77) | 31 014 (56.92) | 19.9 | 1.33* (1.31, 1.35) | 1.30 | |
Note. AI/AN = American Indian/Alaska Native; CHSDA = Contract Health Service Delivery Area; CI = confidence interval; IHS = Indian Health Service; RR = rate ratio. Analyses are limited to persons of non-Hispanic origin. AI/AN race is reported by National Program of Cancer Registries and Surveillance, Epidemiology, and End Results registries or through linkage with the IHS patient registration database. Rates are per 100 000 persons and are age-adjusted to the 2000 US standard population (19 age groups; Census P25-1130). Rate ratios are calculated in SEER*Stat before rounding of rates and may not equal RRs calculated from rates presented in table. IHS regions are defined as follows: Alaskab; Northern Plains (IL, IN,b IA,b MI,b MN,b MT,b NE,b ND,b SD,b WI,b WYb); Southern Plains (OK,b KS,b TXb); Southwest (AZ,b CO,b NV,b NM,b UTb); Pacific Coast (CA,b ID,b OR,b WA,b HI); East (AL,b AR, CT,b DE, FL,b GA, KY, LA,b ME,b MD, MA,b MS,b MO, NH, NJ, NY,b NC,b OH, PA,b RI,b SC,b TN, VT, VA, WV, DC). Percentage regional coverage of AI/AN persons in CHSDA counties to AI/AN persons in all counties: Northern Plains = 64.8%; Alaska = 100%; Southern Plains = 76.3%; Southwest = 91.3%; Pacific Coast = 71.3%; East = 18.2%; total US = 64.2%.
Source. Incidence data are from population-based cancer registries that participate in the National Program of Cancer Registries or the Surveillance, Epidemiology, and End Results Registries (43 states): AK, AL, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, TX, UT, VT, WA, WV, WY; 1999–2008: WI; 1999–2001 and 2003–2009: DC; 2001–2009: AR, NC, SD; 2002–2009: VA; 2003–2009: MS, TN.
RRs between rate for AI/AN persons and rate for White persons by stage.
Identifies states with at least 1 county designated as CHSDA.
*P < .05.