Colon Cancer Facts and Figures for Michigan Native Americans – Incidence rates, Age at diagnosis, and screening rates

Noel Pingatore, B.S. CPH Department of Health Education and Chronic Disease September 25, 2013

Incidence rates – Emily Rohen, MPH and Glenn Copeland, State Cancer Registry, 2012 Leading Primary Sites by Race and Sex Michigan Residents, 1995 - 2004 Rank 1 2 3 4 5 6 7 8 9 10 White Male Site Number Prostate Lung Colon Bladder Non-Hodgkin Melanoma Rectum Leukemia Kidney Oral 69214 36270 16537 16500 9434 9127 7494 6877 6771 6313 Rate 183.8

97.4

46.0

45.7

25.0

23.7

20.0

18.7

17.6

16.3

Rank 1 2 3 4 5 5 7 8 9 American Indian Male Site Number Rate Prostate Lung Colon Rectum Bladder Oral Kidney Non-Hodgkin Liver Leukemia 187 174 74 42 40 37 33 30 26 26 125.1

119.5

45.6

25.3

35.6

19.5

17.1

15.8

15.7

14.6

Rank 1 2 3 4 5 6 7 8 9 10 White Female Site Number Breast Lung Colon Corpus Uteri Non-Hodgkin Ovary Melanoma Rectum Bladder Leukemia 62405 28413 17558 12573 8864 7825 7393 6101 5446 5358 Rate 135.5

59.6

35.2

27.2

18.6

17.0

16.8

12.7

11.1

11.3

* Rate is considered statistically unreliable.

Rank American Indian Female Site Number Rate 1 2 3 4 5 6 7 8 9 10 Breast Lung Colon Corpus Uteri Ovary Kidney Cervix Uteri Non-Hodgkin Rectum Leukemia Melanoma 236 176 68 44 28 26 25 24 23 18 18 95.9

84.8

35.1

17.1

11.8

10.9

9.5

9.0

11.9

* *

Age at Diagnosis:

White American Indian

Men 50+ Men < 50 91% 8% 70% 29% Women 50+ 98% 79% Women <50 7% 21% More American Indians are diagnosed at a younger age compared to the general/white population Suggests a need to further research and a review of screening guidelines Genetic Component

Colon Cancer Screening Rates – Michigan Cancer Consortium SCRBS 2008 – Native American Respondents • FOBT w/in past year = 28.3% • Flex Sig w/in past 5 years = 30.4% • Colonoscopy w/in past 10 years = 41.9% HP 2020 target 70.5%

Summary: • Incidence rates are comparable to other groups • In Michigan, more AI are diagnosed at younger ages ( outside of screening recommendations at age 50) than the general population • Need to increase screening rates HP 2020, GPRA measures, etc.