Generating a tribe-specific cancer report for the Navajo Nation, 1995-2004

Cancer has emerged as a leading cause of illness and death among the Navajo people. The Navajo Epidemiology Center, a program within the Navajo Nation Division of Health, collaborated with the Navajo Cancer Workgroup –comprised of health care providers, public health professionals, and tribal members - to analyze cancer data and produce a Navajo Cancer report. The report included Navajo-specific cancer incidence rates, stage of diagnosis, cancer mortality rates, and cancer screening estimates. Navajo cancer cases were identified from population-based cancer registries of Arizona and New Mexico that conduct cancer surveillance for the Navajo Nation. Age-adjusted cancer incidence and mortality rates were calculated by the direct method. Population estimates for incidence and mortality rates were derived from multiple sources. Cancer data were linked with the Indian Health Service patient registration database to reduce racial and tribal misclassification. Breast, prostate, and colon/rectum were the common types of cancer among the Navajo, though incidence rates for these cancers were lower than non-Hispanic whites (NHW). Conversely, incidence rates for cancers of the stomach, liver, and gallbladder were higher among the Navajo than among NHW. Navajos were generally diagnosed at later stages of disease than NHW for screen-detectable cancers. Rates of screening were lower for Navajos than for NHW. This project presented Navajo-specific cancer data, demonstrating the Navajo Nation's ability to utilize and analyze its own cancer data. By better understanding the occurrence and patterns of cancer among Navajos, Navajo Nation is better positioned to develop culturally appropriate solutions, interventions, and relevant research.