Cancer Screening and Care for AIANs in Washington State.ppt

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) 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 Documenting the problem First step: Examine Washington State Cancer Registry records AIAN vs. non-AIAN Medicaid vs. non-Medicaid 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)? 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 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 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 Early Results Time from diagnosis to surgery (months) Washington State, 1997-2003 Planned analyses % of patients receiving appropriate treatment How distance to provider affects quality of cancer care Survival (when possible) 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