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We describe and compare cancer incidence and mortality among American Indians (AI/ANs) and whites in nine Indian Health Service (IHS) Service Units in Oklahoma.Using data from the Oklahoma Central Cancer Registry and the web-based OK2SHARE database, we obtained age-adjusted cancer incidence rates from 1997 to 2012 and cancer mortality rates from 1999 to 2009 for AI/ANs and whites in Oklahoma. We examined differences in primary site, percentage of late stage diagnoses, and trends over time.AI/ANs consistently had higher cancer incidence and mortality compared to whites in Oklahoma. The magnitude of disparity for cancer incidence and mortality varied by IHS Service Unit and by gender. The top three cancer sites were the same for all Service Units. The percentage of late stage diagnosis also varied by region.We identify priority areas where cancer disparity challenges exist among AI/ANs in Oklahoma.

This study assessed the period prevalence (2000-2008) and mortality rates of melanoma, in Oklahoma, among different racial/ethnic strata.We analyzed incident cases of melanoma from 2000-2008 from the Oklahoma Central Cancer Registry and determined disease duration using Kaplan-Meier survival analysis to calculate period prevalence of melanoma in Oklahoma. Using a series of Chi-Square tests, we compared period prevalence and mortality rates among the racial groups and compared mortality between Oklahoma and the US.White non-Hispanics in Oklahoma have the highest period prevalence (p0.0001) among the racial strata. American Indian or Alaska Native (AI/AN) individuals have the second highest period prevalence in Oklahoma (p0.0001). Furthermore, white non-Hispanics (p0.0001) and AI/AN individuals (p=0.0003) in Oklahoma had higher mortality rates compared to the US.There are disparities in the prevalence and mortality of melanoma among the AI/AN population in Oklahoma, and prevention and education programs should focus on this population.

Cancer is the second-leading cause of death in the United States (US) and Oklahoma ranks near the top with the highest rates of mortality from cancer. The top four major sites of cancer were prostate, female breast, lung and bronchus, and colon and rectum.Joinpoint software was used to examine the incidence and mortality for the four cancers over time from 1999-2012 for both the US and Oklahoma.Incidence and mortality rates declined from 1999-2012 for the four cancer sites. The average annual, age-adjusted incidence rate was higher in the US than Oklahoma for prostate cancer, but higher in Oklahoma for female breast, lung and bronchus, and colon and rectum cancer sites.Over the course of 14 years from 1999-2012, the age-adjusted incidence and mortality rates of prostate cancer, female breast cancer, lung and bronchus cancer, and colon and rectum cancer decreased over time nationally and in Oklahoma.

While cancer is relatively rare in children under 20, it is the leading cause of disease-related death among children aged 5 to 14 years. We aimed to describe the incidence and survival of childhood cancer in Oklahoma from 1997-2012. We calculated age-adjusted incidence rates and five-year observed survival by cancer type using Oklahoma Central Cancer Registry and Surveillance, Epidemiology, and End Results program data among children diagnosed with cancer under the age of 20 from 1997-2012. The average annual age-adjusted incidence rate of childhood cancer was 168.9 per million for the US and 171.7 per million for Oklahoma. Overall, Oklahoma had lower survival from childhood cancer compared to the US (77.0% v. 80.6%). In recent years, research has been conducted on the epidemiology of childhood cancer. Little research has been done, however, on the incidence or survival of childhood cancer at state levels and none focused exclusively on Oklahoma.

This study describes overall and site specific cancer incidence among AI/ANs compared to whites in Oklahoma and differences in cancer staging.Age-adjusted incidence rates obtained from the Oklahoma Central Cancer Registry are presented for all cancer sites combined and for the most common cancer sites among AI/ANs with comparisons to whites. Percentages of late stage cancers for breast, colorectal, and melanoma cancers are also presented.AI/ANs had a significantly higher overall cancer incidence rate compared to whites (629.8/100,000 vs. 503.3/100,000), with a rate ratio of 1.25 (95% CI: 1.22, 1.28). There was a significant disparity in the percentage of late stage melanoma cancers between 2005 and 2009, with 14.0% late stage melanoma for whites and 20.0% for AI/ANs (p-value:0.03).Overall, there were cancer disparities between AI/ANs and whites in Oklahoma. Incidence rates were higher among AI/ANs for all cancers and many site specific cancers.

Obesity and smoking are the two modifiable risk factors that contribute the most for many chronic diseases. Obesity has nearly doubled in Oklahoma and in the US since 1990 while Oklahoma adult smoking rates have remained above 25%. The purpose of this study was to utilize the Behavioral Risk Factor Surveillance System (BRFSS) to describe the associations between overweight, obesity, and cigarette smoking with selected chronic diseases among Oklahoma adults. The BRFSS is an ongoing, state-based, random-digit dialing telephone survey of the non-institutionalized adult population ages 18 years and older designed to collect various kinds of health-related information. Descriptive statistics were obtained for high blood pressure, high cholesterol, diabetes, asthma, and arthritis by BMI status (i.e. not overweight, overweight, obese) and smoking status (i.e., current, former, never). Logistic regression was performed to test for associations between BMI status or smoking status and these diseases. Self-reported diabetes, arthritis, and lifetime high blood pressure and high cholesterol rates were higher among those who were overweight and highest among those who were obese, while asthma rates were higher among obese adults than those who were not obese. Asthma rates were higher for those who currently smoke than former smokers and never smokers. Former smokers had significantly higher rates of high blood pressure, high cholesterol, diabetes, and arthritis compared to never smokers or current smokers.

The objective was to estimate the rates of behavior-related risk factors among American Indians in Oklahoma, and compare those to the Oklahoma general population rates and Healthy People 2010 goals where available.The REACH 2010 Native American Behavioral Risk Factor Survey, a random telephone survey, was conducted in 2000 as a part of the larger national REACH initiative. It had 3,732 respondents and it included measures related to health status, health care access, overweight, exercise, tobacco use, alcohol use, hypertension, cholesterol screening and diabetes.Self-reported health status was excellent or very good among 52% of respondents and fair or poor among 21%. Sixty-one percent of adults were overweight or obese. Prevalence of current cigarette smoking was at 33%. Binge drinking in the last month was present among 18% of American Indian adults. Thirty percent of adults did not engage in any leisure time physical activity during the last month. Diagnosed high blood pressure was reported by 26% of respondents, and prevalence of diabetes exceeded 8%.Majority of the recorded behaviors are above Healthy People 2010 goals, and exceed Oklahoma general population rates. There are also some significant gender differences, demonstrating the need for targeted intervention activities.

Tobacco use among American Indians in the US is higher compared to the overall population. Little is known, however, about tobacco use among Native Americans in Oklahoma. The objective of this paper is to report the prevalence of current cigarette smoking among the Native American population in Oklahoma and compare these rates to Oklahoma general adult population rates and United States median rates. The REACH 2010 Native American Behavioral Risk Factor Survey, a random telephone survey, was conducted in 2000 as a part of larger national REACH initiative. It was designed to over-sample Native Americans in Oklahoma, and collect information related to diabetes, cardiovascular disease, overweight and obesity, physical activity, tobacco use, and other behavioral risk factors of interest. The prevalence of current cigarette smoking was significantly higher among Native American adults in Oklahoma (33%) as compared to the Oklahoma general adult population current smoking rate (23%), and U.S. median rate (23%). It was also greater than smoking rates for other racial and/or ethnic groups in Oklahoma. For Native Americans in Oklahoma as well as for Oklahoma and U.S. general populations, highest cigarette smoking rates were among men, younger age groups, and those of lower socioeconomic status, all following the same trend. These findings are urging for more interventions targeting groups with higher smoking rates.