Cancer among indigenous populations. The experience of American Samoans.

BACKGROUND: Little is known about the cancer control needs of American Samoans. This report provides some of the first data on cancer incidence among American Samoans in Hawaii.
METHODS: The Hawaii Tumor Registry, a Surveillance, Epidemiology, and End Results population-based, active cancer surveillance program, provided archival data on American Samoans residing in Hawaii and on those referred to Hawaii for diagnosis and treatment from the U.S. Territory of American Samoa.
RESULTS: In American Samoan males, the more commonly encountered cancers included cancer of the lung, prostate, stomach and liver, and leukemia. In American Samoans females, breast carcinoma was most frequent, followed by cancer of the corpus uteri, cervix uteri and thyroid, and leukemia. Females were more likely than males to receive a diagnosis of cancer at an early age: 34.5% of females and 19.9% of males with cancer were diagnosed when they were between the ages of 0 and 44 years. Males were more likely than females to be diagnosed with cancer after metastasis had occurred (45% vs. 33.9%). Compared with other Polynesians (i.e., Western Samoans and Hawaiians), American Samoan males have a relatively higher frequency of lung, prostate, thyroid, and liver cancers and a lower frequency of colon and rectum cancers. American Samoan females, compared with other Polynesians, have a higher frequency of leukemia and corpus uteri, thyroid, and pancreatic cancers and a lower frequency of colon and rectum cancers.
CONCLUSIONS: The data provide baseline information that has important public health and research implications for cancer control programs for this population.