U.S. Cancer Statistics American Indian and Alaska Native Incidence Data

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Accurate determination of disease burden is a critical first step toward identifying health disparities. More American Indian and Alaska Native patients are misclassified as another race in cancer registry records than patients in other racial groups. This misclassification can result in underestimates of cancer incidence among American Indian and Alaska Native people. Cancer incidence data from the central cancer registries have been linked with the Indian Health Service (IHS) patient registration database for improved accuracy of racial classification.

Another way to improve the precision of cancer statistics for American Indian and Alaska Native people is to restrict statistical analyses to areas with health care services provided by the IHS. IHS purchased/referred care delivery areas (PRCDAs) consist of counties that include all or part of an American Indian or Alaska Native reservation, as well as any county that has a common boundary with a reservation. Updates to the PRCDA list are published in the Federal Register.

The U.S. Cancer Statistics American Indian and Alaska Native Incidence Analytic Database is restricted to populations residing in PRCDA counties (defined in the October 19, 2017 Federal Register (82 FR 47004)). The database includes incidence data from CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program.

States and Purchased/Referred Care Delivery Area Counties by IHS Region: United States
Map of the United States showing the states and Purchased/Referred Care Delivery Area (PRCDA) counties by IHS Region: United States. The IHS Regions are East, Northern Plains, Southern Plains, Southwest, Pacific Coast, Alaska, and Hawaii. States within the East IHS Region having PRCDA counties are Maine, Massachusetts, New York, Pennsylvania, Virginia, South Carolina, Florida, Alabama, Mississippi, and Louisiana. All states in the Northern Plains, except for Illinois, have PRCDA counties. All states on the Southern Plains, Southwest, and Pacific Coast IHS regions have PRCDA counties, as well as Alaska. Hawaii does not have PRCDA counties.

Map of the United States showing the states and PRCDA counties by IHS region. The IHS regions are East, Northern Plains, Southern Plains, Southwest, Pacific Coast, and Alaska. States in the East IHS region with PRCDA counties are Alabama, Connecticut, Florida, Louisiana, Maine, Massachusetts, Mississippi, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, and Virginia. All states in the Northern Plains except Illinois have PRCDA counties. All states in the Southern Plains, Southwest, and Pacific Coast IHS regions, as well as Alaska, have PRCDA counties. Hawaii does not have PRCDA counties.

The U.S. Cancer Statistics American Indian and Alaska Native Incidence Analytic Database can be used to—

  • Describe the incidence of cancer.
  • Identify American Indian and Alaska Native populations most affected by cancer.
  • Evaluate cancer prevention and screening activities.
  • Assess cancer disparities.

You can use the American Indian and Alaska Native restricted to PRCDA only module in the U.S. Cancer Statistics Data Visualizations tool to explore the data. The module includes the latest and most complete cancer data for American Indian and Alaska Native people.

The American Indian and Alaska Native restricted to PRCDA only module provides interactive graphics and data interpretations—

  • For new cancer cases.
  • By IHS region.
  • By sex and age.
  • By type of cancer.
Page last reviewed: June 6, 2022
Content source: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention