In the Special Feature section of the Report, the authors found that while the top three cancers for men and for women are the same for AI/AN and NHW populations, there are important differences by region and type of cancer, including:

* For all cancers combined, AI/AN incidence rates were lower in the Southwest and higher in the Plains and Alaska
* Lung and colorectal cancer incidence rates were highest in the Northern Plains and Alaska and were significantly elevated in comparison with NHW rates

* The incidence rates for cancers of the kidney, stomach, liver, cervix and gallbladder were higher in AI/AN than in NHW populations in all regions combined
* With the exception of Alaska, AI/AN persons were less likely than NHW persons to be diagnosed with early stages of colorectal cancer, with the difference being larger in the Southwest, Northern Plains, and Southern Plains than other regions
* AI/AN women in all regions of the U.S. were less likely than NHW women to be diagnosed with localized breast cancer.

"We are firmly committed to addressing cancer health disparities so that the benefits of decades of research can reach all Americans," said National Cancer Institute (NCI) Director John E. Niederhuber, M.D. "The fact that lung and colorectal cancers rates were higher in some American Indian and Alaska Native populations points to the work we still have to do."

AI/AN populations were more likely to live in poverty and less likely to have a high school education and health coverage when compared to NHW persons, all indicators of less access to cancer prevention and control services. Also, current smoking rates were high among AI/AN overall, with the highest prevalence among AI/AN in Alaska and in the Northern Plains; in all regions, more AI/AN than NHW persons reported being obese; and screening rates for breast, colorectal, prostate and cervical cancers were lower among AI/AN than NHW persons.

"We now have an infrastructure in this country for obtaining high-quality information about new cases of cancer and we can now describe the successes in cancer interventions and treatment as well as uncover populations with varying risks and outcomes," said Holly L. Howe, Ph.D., executive director of North American Association of Central Cancer Registries (NAACCR). "Without this surveillance, we would be ill-equipped to address the challenges we face in further reducing the cancer burden."

The authors report that earlier detection of disease through screening, improved prognosis through more effective treatment, tobacco control, and reduction in inequalities in cancer care all point to the success of the nation's dedication and focus on reducing the burden of cancer in the U.S.

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