Improving the accuracy of cancer rates for American Indians in New York State

In the 2000 Census, New York State had about 82,000 single-race American Indians, with about 47,000 indicating a specific tribal affiliation. The largest affiliations were Iroquois (18,000, encompassing Mohawk, Seneca, Onondaga and several other groups, about half of whom were living on or near one of six upstate reservation areas), Latin American Indians (11,000, primarily in New York City), and Cherokee (3,000, also primarily in New York City). Throughout the state, the number of American Indian cancer cases is well below what would be expected given the population sizes. The purpose of our project was to identify additional America Indian cancer cases that were miscoded in the New York State Cancer Registry. We pursued several strategies that increased rates by as much as 50%: linkage to the Indian Health Service, geographic-based assignment, and surname-based assignment. New York State now has a much more accurate picture of the cancer burden among its American Indian population living outside of New York City.