Authors: Lukejohn W Day David K Espey Erin Madden Mark Segal Jonathan P Terdiman
Publish Date: 2011/01/14
Volume: 56, Issue: 7, Pages: 2104-2113
Abstract
A retrospective cohort study of AI/AN who utilized IHS from 1996 to 2004 AI/AN who were averagerisk for CRC and received primary care within IHS were identified by searching the IHS Resource Patient Management System for selected ICD9/CPT codes n = 142051 CRC screening prevalence was calculated and predictors of screening were determined for this group CRC incidence rates were ascertained for the entire AI/AN population ages 50–80 who received IHS medical care between 1996 and 2004 n = 283717CRC screening was performed in 40 of averagerisk AI/AN CRC screening was more common among women than men RR = 16 95 CI 14–17 and among AI/AN living in the Alaska region compared to the Pacific Coast region RR = 25 95 CI 22–28 while patients living in the Northern Plains RR = 04 95 CI 03–04 were less likely to have been screened CRC screening was less common among patients with a greater number of primary care visits The ageadjusted CRC incidence among AI/AN ages 50–80 was 227 cancers per 100000 personyearsColorectal cancer CRC is a leading cause of morbidity and mortality among American Indian/Alaskan Natives AI/AN 1 AI/AN have more advanced disease 2 and lower survival rates 3 and there has been no change in CRC mortality rates over the last decade for AI/AN 4One important question that warrants further attention is how well CRC screening services are provided to AI/AN While there are more data assessing CRC screening and development of screening programs for Hispanics 5 6 Asians 7 8 and African–Americans 9 10 11 there are few studies that report the CRC screening experience of AI/AN Existing studies on this topic have been hampered by small numbers of AI/AN included racial misclassification and methodological problems 4 12 13 14
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