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139th National Cancer Advisory Board

working on the 2007 Annual Report, which will feature data on American Indians and Alaska Natives. For further information, the NCAB members were invited to visit several Web sites: www.interscience.wiley.com/cancer/report2006; http://www.cancer.gov; http://www.seer.cancer.gov/; and http://www.naaccr.org.

Questions and Answers

Dr. Runowicz queried whether the decline in incidence and mortality related to colorectal cancer that occurred in the mid 1980s was related to diet. Dr. Edwards responded that good data on risk factors for colorectal cancer are unavailable, but agreed that cooking methods may be related. Dr. Coffey noted that treatment of one disease or condition might increase the incidence of another; examples include Helicobacter pylori and flora in the esophagus, which is defensive against Barrett’s esophageal lesions. Additionally, the decreased use of hormone replacement might reduce the incidence of breast cancer but increase the occurrence of colorectal cancer.

Dr. Chabner commented that information about stage migration within some of the categories of tumors that are decreasing in incidence would help determine whether early detection or improved therapy is the cause. Dr. Edwards mentioned that the SEER Program collects information on stage, particularly with breast cancer, but quantitative data to clarify stage migratory factors in detail are limited or not available.

Dr. Chen queried about the challenges that had to be overcome to be able to measure Hispanics as an entity, and the obstacles to address other populations, such as the American Indians, Alaska Natives, Asian Americans, and Native Hawaiians, to obtain similar data. Dr. Edwards explained that, because cancer information from the registries funded by the NCI and the CDC include race and ethnicity data, the registry community has adopted a strategy to compare cancer patient names with the 1990 Census information, and run a probability algorithm to determine the likelihood of a person with unknown ethnicity being attributed to the Hispanic population. The NCI used this approach in Louisiana, where they have some of the names from the Cajun populations, and they felt they had too many Hispanics. For the American Indian population, the work has included a linkage with the Indian Health Service (IHS) medical delivery system, requiring a three-way agreement. To accommodate sensitivities from that population, the cancer registries send their information to the IHS under secure condition, which maintains the list of names and determines whether that person has received care in the IHS system. If cancer patients are identified as receiving care from the IHS information, registry records with missing information can be corrected and thereby improve the identification of American Indians and Alaska Natives diagnosed with cancer. A names-list approach is being proposed for use with the Asian Pacific Island population as well.


Dr. Runowicz thanked all of the Board members, as well as all of the visitors and observers, for attending.

There being no further business, the 139th regular meeting of the NCAB was adjourned at 11:44 a.m. on Thursday, September 7, 2006.

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