Emily Roen

Cancer Incidence and Mortality Within Northern Michigan American Indian Populations

Cancer incidence and mortality is an important public health issue, and historically these rates among American Indian Alaskan Native (AIAN) populations have been significantly underestimated. Figures have suggested that cancer incidence and mortality rates among these populations are around half those of other racial populations (1,2). However, racial misclassification is a major problem for cancer surveillance programs among AIAN populations. Nationwide data recorded lower rates for both cancer incidence and mortality (all cancers included) for American Indians than Whites and African Americans but higher rates compared to Hispanic and Asian populations. This data however, may reflect the inaccuracies in cancer data for American Indians (2). According the American Cancer Society there is incomplete cancer information for American Indians because many individuals were unable to be identified (2). Previous studies have demonstrated the benefits of linkage techniques for correct racial classification, and after implementing these techniques the true cancer incidence and mortality rates among AIAN communities soared (1). 
This current study builds off of a study, done by Jenna Johnson, MPH, in 2007, which used linkage techniques to create a set of new, adjusted cancer incidence data for one American Indian tribe in Northern Michigan. This adjusted data is significantly more accurate than previous data since the racial classification of AIAN individuals was confirmed (1). Since this study, the Michigan Department of Community Health (MDCH) has continued linkage for four additional tribes in Northern Michigan. This current study aims to use these adjusted data from the MDCH, calculate adjusted cancer incidence and mortality rates and compare these rates to other racial populations in Michigan. The rates will be analyzed to determine if there is a significant difference between populations, and potential reasons for any differences will be investigated.

This project will use the adjusted data on cancer incidence and mortality for the five American Indian tribes in Northern Michigan from the Michigan state registry and compare these statistics with cancer data for other racial groups. Now that the data for the American Indian tribes has been adjusted for racial misclassification, it will be interesting to compare the data with other racial groups (such as the White population or other racial minorities) and investigate whether differences between cancer incidence and / or mortality still exist. The reasons for any differences observed may also be analyzed.

1. Johnson J.C, Soliman A.S, Tadgerson D., Copeland G.E, Seefeld D.A, Pingatore N.L… Roubidoux M.A. (2009). Tribal Linkage and Race Data Quality for American Indians in a State Cancer Registry. American Journal of Preventative Medicine. 36(6), 549-554.
2. American Cancer Society. Cancer Facts & Figures 2012. Atlanta: American Cancer Society; 2012.

Adherence to Screening Mammography among American Indian Women of the Northern Plains 

About Emily
Emily is from Chicago, IL and graduated from the University of Illinois- Urbana with a B.S. in Molecular and Cellular Biology and a minor in Spanish. She graduated from the University Of Michigan School of Public Health with an MPH in General Epidemiology in 2013.