Pediatric and Adolescent Cancers Among American Indian and Alaska Native Peoples

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.