Regional differences in cancer treatment among American Indian and Alaska native peoples: a surveillance, epidemiology, and end results study
9 affiliations
- 1Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA USA
- 2Department of Surgery, University of Arizona, Tucson, AZ USA
- 3Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA USA
- 4Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC USA
- 5Partnership for Native American Cancer Prevention, Northern Arizona University, Arizona, USA
- 6Health Sciences Department, College of Health and Human Services, Northern Arizona University, Flagstaff, AZ USA
- 7University of California San Francisco East Bay General Surgery Residency, San Francisco, CA USA
- 8Monument Health, Rapid City, SD USA
- 9New Mexico Tumor Registry, University of New Mexico Comprehensive Cancer Center, Bldg 229, 1, Albuquerque, NM MSC11 602087131-0001 USA
Abstract
Purpose: To determine whether regional variation in diagnostic procedures and treatment for cancer exists among American Indian and Alaska Native (AIAN) patients.
Methods: We used data from the Surveillance Epidemiology and End Results (SEER) 17 database to examine differences in diagnostic, treatment, and care quality-related variables for female breast, lung, and colorectal cancers diagnosed among AIAN patients. We used unadjusted and multivariable-adjusted logistic regression models to examine differences across Indian Health Service regions adjusted for age at diagnosis, diagnosis year, residence in a purchased/referred care delivery area, and stage at diagnosis, using the Pacific Coast region as the reference.
Results: The study sample included female breast (n=7,221), lung (n=5,403), and colorectal cancer (n=5,626) patients. Among AIAN female breast cancer patients, those in Alaska, the East, and the Southwest had higher odds of timely treatment; those in Alaska had higher odds of receipt of chemotherapy and hormone receptor testing; while those in the Southwest had lower odds of hormone receptor testing. For lung cancer patients, those in Alaska, the Southwest, and the East had higher odds of timely treatment; those in Alaska had higher odds of receiving radiation and lower odds of receiving surgery. Finally, for colorectal cancer patients, those in Alaska, the Southwest, and the East had higher odds of receiving timely treatment.
Conclusions: Differences described herein may reflect differences in clinical characteristics, practice patterns, or access to care. Further research on how treatment differences lead to regional variations in cancer outcomes for AIAN patients are warranted.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10552-026-02271-9.
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BibTeX
@article{elenwa2026regional,
title = {{Regional differences in cancer treatment among American Indian and Alaska native peoples: a surveillance, epidemiology, and end results study}},
author = {Faith Elenwa and Jennifer Erdrich and Jamie Sorensen and Vanessa E. Slater and Carol Goldtooth and Priscilla R. Sanderson and Tamee Livermont and Keely Ulmer and Bradley D. McDowell and Sarah H. Nash,},
journal = {Cancer Causes \& Control},
year = {2026},
month = nov,
doi = {10.1007/s10552-026-02271-9},
url = {https://doi.org/10.1007/s10552-026-02271-9},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Regional differences in cancer treatment among American Indian and Alaska native peoples: a surveillance, epidemiology, and end results study
AU - Faith Elenwa
AU - Jennifer Erdrich
AU - Jamie Sorensen
AU - Vanessa E. Slater
AU - Carol Goldtooth
AU - Priscilla R. Sanderson
AU - Tamee Livermont
AU - Keely Ulmer
AU - Bradley D. McDowell
AU - Sarah H. Nash,
PY - 2026
DA - 2026/11/03
JO - Cancer Causes & Control
DO - 10.1007/s10552-026-02271-9
UR - https://doi.org/10.1007/s10552-026-02271-9
AB - Purpose: To determine whether regional variation in diagnostic procedures and treatment for cancer exists among American Indian and Alaska Native (AIAN) patients. Methods: We used data from the Surveillance Epidemiology and End Results (SEER) 17 database to examine differences in diagnostic, treatment, and care quality-related variables for female breast, lung, and colorectal cancers diagnosed among AIAN patients. We used unadjusted and multivariable-adjusted logistic regression models to examine differences across Indian Health Service regions adjusted for age at diagnosis, diagnosis year, residence in a purchased/referred care delivery area, and stage at diagnosis, using the Pacific Coast region as the reference. Results: The study sample included female breast (n=7,221), lung (n=5,403), and colorectal cancer (n=5,626) patients. Among AIAN female breast cancer patients, those in Alaska, the East, and the Southwest had higher odds of timely treatment; those in Alaska had higher odds of receipt of chemotherapy and hormone receptor testing; while those in the Southwest had lower odds of hormone receptor testing. For lung cancer patients, those in Alaska, the Southwest, and the East had higher odds of timely treatment; those in Alaska had higher odds of receiving radiation and lower odds of receiving surgery. Finally, for colorectal cancer patients, those in Alaska, the Southwest, and the East had higher odds of receiving timely treatment. Conclusions: Differences described herein may reflect differences in clinical characteristics, practice patterns, or access to care. Further research on how treatment differences lead to regional variations in cancer outcomes for AIAN patients are warranted. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10552-026-02271-9.
SN - 0957-5243
SN - 1573-7225
ER -