. Author manuscript; available in PMC: 2022 Oct 1.

Published in final edited form as: Cancer Epidemiol Biomarkers Prev. 2021 Aug 2;30(10):1799–1806. doi: 10.1158/1055-9965.EPI-21-0343

Table 4.

Incidence rate trends (1999–2017) for colorectal cancer with joinpoint^a analyses for AI/AN^b,c persons compared to White^b persons in PRCDA counties, both sexes combined, United States.

		AAPC^d
IHS region	Race	<50 years	50–64	65–74	75+ years	All ages
Northern Plains	White	+3.0^e	−1.4^e	−4.2^e	−3.3^e	−2.3^e
	AI/AN	+3.6^e	+0.6	−3.8^e	−2.4^e	−1.2^e
Alaska	White	+3.5^e	−0.1	−4.5^e	−4.8^e	−2.8^e
	AI/AN	+3.7^e	−1.4	−2.4^e	−1.3	−1.1^e
Southern Plains	White	+2.3^e	−0.9^e	−2.5^e	−3.4^e	−1.5^e
	AI/AN	+2.8^e	+1.2^e	−1.9^e	−2.2^e	−0.6
Pacific Coast	White	+2.9^e	−0.8^e	−4.2^e	−3.6^e	−2.4^e
	AI/AN	+4.5^e	+0.4	−2.8^e	−4.6^e	−1.3^e
East	White	No value	−2.0^e	−4.2^e	−4.2^e	−2.8^e
	AI/AN	No value	+3.1	−5.1^e	−3.8^e	−0.9
Southwest	White	+2.5^e	−0.7^e	−3.9^e	−3.7^e	−2.3^e
	AI/AN	+3.4^e	+2.4^e	+1.8	+1.2	+2.9^e
All regions	White	+2.5^e	−1.3^e	−4.1^e	−3.8^e	−2.4^e
	AI/AN	+3.7^e	+1.1^e	−2.1^e	−2.0^e	−0.5^e

Note: The percentage of the AI/AN population living in a PRCDA-designated county from 2013–2017 was 53.3% for the United States; by IHS region, these percentages were: Alaska = 100%; Pacific Coast = 60.3%; Southwest = 83.9%; Northern Plains = 54.3%; Southern Plains = 56.7%; and East = 16.8%.

Abbreviations: AI/AN, American Indian/Alaska Native; AAPC, average annual percent change; IHS, Indian Health Service; PRCDA, Purchased/Referred Care Delivery Area.

Joinpoint analyses are based on rates per 100,000 persons and are age adjusted to the 2000 U.S. standard population (11 age groups, Census P25–1130).

Analyses are limited to persons of non-Hispanic origin.

AI/AN race is reported by NPCR and SEER registries or through linkage with the IHS patient registration database.

AAPC is based on rates that were age adjusted to the 2000 U.S. standard population (11 age groups—Census P25–1130).

Indicates AAPC is statistically significantly different from zero (two-sided P < 0.05).

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 - 1998–2017. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Released June 2020, based on the 2019 submission.

IHS regions are defined as follows: Alaska*; Northern Plains (IL, IN*, IA*, MI*, MN*, MT*, NE*, ND*, SD*, WI*, WY*); Southern Plains (OK*, KS*, TX*); Southwest (AZ*, CO*, NV*, NM*, UT*); Pacific Coast (CA*, ID*, OR*, WA*, HI); East (AL*, AR, CT*, DE, FL*, GA, KY, LA*, ME*, MD, MA*, MS*, MO, NH, NJ, NY*, NC*, OH, PA*, RI*, SC*, TN, VT, VA*, WV, DC); * identifies states with at least one county designated as PRCDA.