(1975 through 2004) and fixed-interval (1995 through 2004) incidence and mortality trends were evaluated by annual percent change using regression analyses (2-sided P < .05). Cancer screening, risk factors, socioeconomic characteristics, incidence data, and stage were compiled for non-Hispanic whites (NHW) and AI/AN across 6 regions of the U.S.We thank Andrew Lake, Rick Firth, Danielle Melbert, and Martin Krapcho of Information Management Services, Inc. for assisting in statistical analyses.We also thank Tom Richards and Mary White, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia for assistance with graphics and their helpful comments on the article. Phyllis A. Wingo was under contract with the Indian Health Service for a portion of her work on this manuscript. This article was originally published online on October 15, 2007, and it is presented here with the following modifications: Dr. Wu's degree appears correctly above, and some data was realigned in the tables to improve the readability of the data being presented. The changes do not affect the core data or the conclusions of the article in any way. The publisher apologizes for this oversight and any confusion that may have ensued. Among women, lung cancer incidence rates no longer were increasing and death rates, although they still were increasing slightly, were increasing at a much slower rate than in the past. Breast cancer incidence rates in women decreased CONCLUSIONS. For all races/ethnicities combined in the U.S., favorable trends in incidence and mortality were noted for lung and colorectal cancer in men and women and for breast cancer in women. For the AI/AN population, lower overall cancer incidence and death rates obscured important variations by geographic regions and less favorable healthcare access and socioeconomic status. T he American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to assess the cancer burden in the U.S. The 1998 report documented the first sustained decline in cancer death rates since the 1930s.1 Subsequent reports updated information on trends in incidence and death rates and featured timely, in-depth analyses of selected topics. 2-9 The American Indian and Alaska Native (AI/AN) cancer experience has not been described well except for a few geographic areas. This 2007 report updates the cancer profile for the U.S. and describes regional patterns of cancer in AI/AN using methods that mitigate the effects of race misclassification. MATERIALS AND METHODSCancer Cases, Cancer Deaths, and Population Estimates U.S. cancer deaths, reported to state vital statistics offices and consolidated through CDC's National Vital Statistics System, 12 were coded using the version of the ICD in use at the time of death. [13][14][15][16] Underlying causes of cancer death were grouped according to the SEER cause of death recode f...

BACKGROUNDUnderstanding differences in cancer screening among population groups in 2000 and successes or failures in reducing disparities over time among groups is important for planning a public health strategy to reduce or eliminate health disparities, a major goal of Healthy People 2010 national cancer screening objectives. In 2000, the new cancer control module added to the National Health Interview Survey (NHIS) collected more detailed information on cancer screening compared with previous surveys.METHODSData from the 2000 NHIS and earlier surveys were analyzed to discern patterns and trends in cancer screening practices, including Pap tests, mammography, prostate specific antigen (PSA) screening, and colorectal screening. The data are reported for population subgroups that were defined by a number of demographic and socioeconomic characteristics.RESULTSWomen who were least likely to have had a mammogram within the last 2 years were those with no usual source of health care (61%), women with no health insurance (67%), and women who immigrated to the United States within the last 10 years (61%). Results for Pap tests within the last 3 years were similar. Among both men and women, those least likely to have had a fecal occult blood test or endoscopy within the recommended screening interval had no usual source of care (14% for men and 18% for women), no health insurance (20% for men and 18% for women), or were recent immigrants (20% for men and 18% for women). An analysis of changes in test use since the 1987 survey indicates that the disparities are widening among groups with no usual source of care.CONCLUSIONSNo striking improvements have been observed for the groups with greatest need. Although screening use for most groups has increased since 1987, major disparities remain. Some groups, notably individuals with no usual source of care and the uninsured are falling further behind; and, according to the 2000 data, recent immigrants also experience a significant gap in screening utilization. More attention is needed to overcome screening barriers for these groups if the population benefits of cancer screening are to be achieved. Cancer 2003;97:1528–40. Published 2003 by the American Cancer Society.DOI 10.1002/cncr.11208

Spatial variations in mortality and incidence by type of cancer demonstrated both persistent and emerging challenges for cancer control in AI/AN populations.