Cancer incidence in the Pijao indigenous population of colombia using administrative health records, 1996–2022

Indigenous populations in Colombia experience substantial cancer disparities, yet systematic epidemiological data characterizing cancer burden in specific indigenous communities remain severely limited. To characterize cancer incidence patterns in the Pijao indigenous population using administrative health records from 1996 to 2022. Retrospective cohort study of individuals affiliated with EPSI Pijaos Salud. Among 106,223 total affiliates, the analysis focused on individuals self-identifying as indigenous Pijao. The final analytic cohort comprised 42,094 adults contributing 365,487 person-years (Chiang-adjusted). Incident malignant cancer. Crude and age-standardized incidence rates were calculated using four reference populations. Temporal dynamics were visualized using Lexis diagrams. Among the indigenous Pijao population, 142 incident malignant cancers were identified (59% women; mean age 58 years). Incidence rates adjusted for competing mortality reached 38.9 per 100,000 person-years. Age-standardized rates varied substantially: 27.9 per 100,000 (Māori Standard) versus 44.0 per 100,000 (European Standard), illustrating bias when applying traditional standards to young indigenous cohorts. Site-specific rates (WHO-standardized, per 100,000) were: skin 9.8, breast 3.8, cervical 2.5, and gastric 2.4. Temporal analysis showed marked variation (24.4 to 55.3 per 100,000 across periods), likely reflecting improved confirmed cancer registration following Resolution 247/2014, which mandated high-cost disease reporting rather than early detection programs. Geographic concentration occurred in Ibagué (crude rate 246 per 100,000). Site-specific incidence rates fell substantially below those in indigenous populations with mature surveillance systems (breast: 3.8 vs. 60–80; cervical: 2.5 vs. 11–15 per 100,000). Findings underscore urgent need for national policy mandating formal cancer registries across Colombian indigenous health systems to enable evidence-based resource allocation and targeted interventions.