Assessing Cancer Incidence in American Indian Tribes
Michigan Cancer Surveillance Program
Health event data on American Indians, including cancer incidence, is generally unreliable due to gross under-ascertainment of American Indians in most reporting systems. Improving ascertainment of American Indians relative to cancer incidence data is critical to resolving the persistent inability to assess accurately the risk and trends in cancer among American Indians.
The Michigan Cancer Surveillance Program has conducted links to tribal registers for two Michigan tribes. The resulting files enable tribal health planners to develop detailed cancer incidence information on rates, trends, and staging information specific for their tribe. This enables the tribal health planners to evaluate the data to identify issues of concern, develop targeted interventions, set measurable objectives, and monitor results. These efforts were accomplished while carefully preserving the confidentiality of the registry, the tribal register, and the patient-specific information relative to cancer status.
The persistent lack of reliable health measures for tribal health planners makes health management for these high-risk populations very difficult. Without reliable data on even basic measures for these populations on cancer risk, establishing cancer control objectives and monitoring the success of interventions is impossible. These efforts provide tribal health planners with a tool to measure the health of their tribal members more effectively and to improve their understanding of the health priorities needing focus.