Pediatric and Adolescent Cancers Among American Indian and Alaska Native Peoples.
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OBJECTIVES: To understand the burden of cancer in American Indian and Alaska Native (AIAN) children (0-14 y) and adolescents (15-19 y), and determine relative burden of cancer compared with other racial and ethnic groups. METHODS: We used the Surveillance, Epidemiology, and End Results (SEER) database to examine incidence of and survival from childhood cancers. Analyses were stratified by residence in an Indian Health Service (IHS) purchased/referred care delivery area (PRCDA), and IHS region. RESULTS: Between 2000 and 2022, 1050 cancers were recorded among AIAN children (n = 729 (69.4%)) and adolescents (n = 321 (30.6%)). The cancer incidence rate in AIAN children and adolescents was 161.1 per 1 000 000 population (95% CI, 151.5-171.1), with the highest rates in Alaska [219.4 per 1 000 000 population], and the lowest in the East [81.9 per 1 000 000 population]. Overall 5-year survival for AIAN children and adolescents was 80.0% (95% CI, 0.77-0.82), and ranged from 75% in Alaska to 87% in the Southern Plains. Comparing PRCDA AIAN children and adolescents to other racial and ethnic groups, incidence rate ratios were 1.12, 0.80, 0.92, and 1.04 for non-Hispanic white, non-Hispanic Black, non-Hispanic Asian Pacific Islander, and Hispanic (all races) children and adolescents, respectively. Five-year survival among PRCDA AIAN children and adolescents was 0.83 (95% CI, 0.81-0.85), which was significantly higher than that of non-Hispanic Black (0.79) and lower than that of non-Hispanic white (0.87) children and adolescents. CONCLUSIONS: These findings provide important data on AIAN childhood cancer rates. Future research may investigate causes of increasing cancer rates among AIAN children and lower survival among AIAN and Black children.