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Cancer Screening and Care for AIANs in Washington State

Cancer Screening and Care for AIANs in Washington State. Scott Ramsey Fred Hutchinson Cancer Research Center. Cancer care disparities. Case studies suggest for AIANs: Less access to screening services (mammography, colonoscopy) Diagnosed at later cancer stages (harder to treat)

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Cancer Screening and Care for AIANs in Washington State

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  1. Cancer Screening and Care for AIANs in Washington State Scott Ramsey Fred Hutchinson Cancer Research Center

  2. Cancer care disparities • Case studies suggest for AIANs: • Less access to screening services (mammography, colonoscopy) • Diagnosed at later cancer stages (harder to treat) • May drop out of cancer care before it’s completed • We don’t have hard data looking at patterns of cancer care to show the disparities • We need to call attention to the details of the disparities to get funding to reduce them

  3. Documenting the problem • First step: • Examine Washington State Cancer Registry records • AIAN vs. non-AIAN • Medicaid vs. non-Medicaid

  4. Ongoing project: Cancer Care for AIAN Access Did the patient get the right treatment? Did it happen at the right time? Was treatment of sufficient duration? Outcomes How does survival for AIANs compare to non- AIANs with the same cancer (and cancer stage at diagnosis)?

  5. How will we get the data? • Partnership with Northwest Portland Area Indian Health Board • NW Tribal Registry Project • Combine data from three sources: • Northwest Tribal Registry • The WA State Cancer Registry • The WA State Medicaid claims database

  6. Objective of the linkage • A dataset of all cancer care services for AIAN patients paid for by Washington State Medicaid • Can analyze patterns of cancer care for AIANs (in WA) and compare to the non-AIAN Medicaid cancer patients

  7. Confidentiality maintained • Names used only to link up the data • After the link, names are removed • No other identifying information either • Analyses will look at Native patients in WA as a group • No comparing of tribes

  8. Early Results

  9. 48% of AIAN with cancer enrolled in Medicaid at or following diagnosis 12% of non-AIAN enrolled at or following diagnosis

  10. Time from diagnosis to surgery (months)Washington State, 1997-2003 █ Breast - Local/Regional █ Lung - Local/Regional █ Colorectal - Local/Regional

  11. Planned analyses • % of patients receiving appropriate treatment • How distance to provider affects quality of cancer care • Survival (when possible)

  12. Future directions • Look at cancer care for AIANs who aren’t enrolled in Medicaid • IHS contract health service providers • Look at use of cancer screening for AIANs • New NCI-funded project starting Summer 2007 • Expand analysis to Oregon and California • Includes interviews of Native cancer survivors, to be conducted by NPAIHB

  13. Timeline • Winter 2006 • Screening analysis project was approved by resolution by the NPAIHB delegates • Spring 2007 • Acquiring updated cancer diagnosis information (including 2004 diagnoses) and Medicaid data for Washington State • Summer 2007 • Completing IRB and data use applications to acquire data from Idaho and Oregon cancer registries for linkage with RPMS data

  14. Questions? Concerns?

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