Lin G, Filos V, Ryan J, Zhang Y, Pu J, Qu M., Nebraska Department of Health and Human Services., 2009 Jun 01
AbstractThis report intends to identify and document cancer disparities by race and ethnicity in Nebraska between 1991 and 2005. The report also examines cancer status and trends at the same period in terms of incidence, staging, and survival with an emphasis on incidence, either by cancer site or by geography for the following mutually exclusive racial/ethnic groups: non-Hispanic whites, non-Hispanic African Americans, non-Hispanic American Indians/Alaska Natives, non-Hispanic Asians and Pacific Islanders, Hispanic whites, and Other Races with Hispanic Origin.
In general, differences in the incidence among major cancer sites, such as breast, colorectal, lung, prostate by race and ethnicity, exhibit patterns and trends similar to those at the national level. In addition, differences in early stage diagnoses and five-year survival rates favoring non-Hispanic whites remain throughout the study period.
In particular, non-Hispanic African Americans and non-Hispanic whites had a heavier and more persistent burden for prostate cancer than other groups, although the trend for non-Hispanic whites declined. There was an increasing trend in lung cancer incidence for non-Hispanic white females.
Measures specifically targeting lung cancer risk factors for white females should be considered. The state incidence rate for cervical cancer between 1991 and 2000 among non-Hispanic Asians was two to three times higher than the national rate for Asians. The higher state rate can be attributed, in part, to a relatively high proportion of Vietnamese Americans among the Asian population in Nebraska.
American Indians in Nebraska share similar cancer risk factors as Northern Plains American Indians and had much higher incidence rates for many types of cancer than the corresponding national population. Localized cancer risk identification and intervention are needed to target American Indians in Nebraska.
The rate of late-stage cancer at diagnosis is inversely related to the five-year survival rate. Nebraska’s non-Hispanic African Americans and American Indians had the highest rate of late-stage cancer at diagnosis and the lowest five-year survival rate of all racial and ethnic groups. Since minority populations are concentrated in a few counties in Nebraska with evident geographic staging and survival patterns, more localized efforts to increase the opportunity for early cancer diagnosis among minority populations should be implemented.
The Hispanic white population increased rapidly in Nebraska during the study period, and this population tended to have relatively low incidence rates for most cancer sites. It is not clear whether the low incidence was due to the characteristics of in-migrants of Hispanic origin or due to this population’s low number of risk factors, or due to the underreporting of Hispanic ethnicity in the census population.