Using tribal data linkages to improve the quality of american indian cancer data in Michigan

Tess L. Weber, Glenn Copeland, Noel Pingatore, Kendra K. Schmid, Melissa A. Jim, Shinobu Watanabe-Galloway

Research output: Contribution to journalArticle


This study examines the extent to which data linkages between Indian Health Service, tribal data, and cancer registries affect cancer incidence rates among American Indians/ Alaska Natives (AI/ ANs) in Michigan. The incidence of tobacco- and alcohol- associated cancers for 1995- 2012 was analyzed to compare rates of the Upper Peninsula (UP) and Lower Peninsula (LP) in Michigan and among AI/ ANs and non- Hispanic Whites (NHWs). Complete linkage resulted in 1,352 additional AI/ AN cases; 141 cases were linked via IHS records alone, while 373 were linked via tribal records alone; 838 were linked through both IHS and tribal records. Age- adjusted incidence rates for AI/ ANs increased from 214.39 per 100,000 to 405.41 per 100,000, similar to that of NHWs after complete linkage (421.46 per 100,000). In the UP, AI/ ANs had age- adjusted incidence rates 1.67 times higher than NHWs (596.69 per 100,000 vs. 356.32 per 100,000 respectively). This study indicates a substantial number of AI/ AN cancer cases remain misclassified in Michigan.

Original languageEnglish (US)
Pages (from-to)1237-1247
Number of pages11
JournalJournal of health care for the poor and underserved
Issue number3
Publication statusPublished - Aug 2019



  • American indian
  • Cancer incidence
  • Data linkage
  • Data quality
  • Epidemiology
  • Michigan

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this