Jr. Sugarman et al., CANCER SURVIVAL AMONG AMERICAN-INDIANS IN WESTERN WASHINGTON-STATE (UNITED-STATES), CCC. Cancer causes & control, 5(5), 1994, pp. 440-448
Cancer survival among American Indians is worse than among other races
in some regions of the United States, but has not been studied among
American Indians in Washington state. Our purpose was to evaluate canc
er survival among American Indians included in the Seattle-Puget Sound
Cancer Registry. We compared site-specific survival among American In
dians (n = 551) and Whites (n = 110,899) diagnosed from 1974 to 1989 f
or five cancer sites. For all sites except prostate, the distribution
of cancer stage at diagnosis for American Indians was not significantl
y different from the distribution for Whites, and a similar proportion
of American Indians and Whites received cancer treatment. After adjus
tment for age differences between American Indians and Whites, America
n Indians experienced poorer survival from prostate, breast, cervical,
and colorectal cancer. Poorer survival among American Indians persist
ed after adjustment for differences in cancer stage at diagnosis, lack
of cancer treatment, and residence in a non-urban county. The surviva
l experience among American Indians who were recorded as non-American
Indians in the cancer registry but who were listed as American Indians
in Indian Health Service records was more favorable than that among p
ersons initially coded as American Indians in the cancer registry. We
conclude that cancer survival among American Indians in western Washin
gton is poorer than that among Whites in the same region, and that fac
tors other than age, differences in stage at diagnosis, lack of cancer
treatment, and residence in non-urban counties account for this.