{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:47:24Z","timestamp":1760986044807,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2021,10,16]],"date-time":"2021-10-16T00:00:00Z","timestamp":1634342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The purpose of this study was to determine the incidence of HPV-positive (HPV+) and HPV-negative (HPV-) head and neck cancer (HNC) in the American Indian\/Alaska Native (AI\/AN) population in California to assess whether incidence is higher among AI\/ANs compared to other ethnicities. We analyzed data from the California Cancer Registry, which contains data reported to the Cancer Surveillance Section of the Department of Public Health. A total of 51,289 HNC patients were identified for the years 2009\u20132018. Outcomes of interest included sex, stage at presentation, 5-year survival rate, tobacco use, and HPV status. AI\/AN and White patients had the highest burden of late stage HNC (AI\/AN 6.3:100,000; 95% CI 5.3\u20137.4, White 5.8:100,000; 95% CI 5.7\u20135.9) compared to all ethnicities or races (Black: 5.2; 95% CI 4.9\u20135.5; Asian\/Pacific Islander: 3.2; 95% CI 3\u20133.3; and Hispanic: 3.1; 95% CI 3\u20133.2 per 100,000). Additionally, AI\/AN and White patients had the highest burden of HPV+ lip, oral cavity, and pharynx HNC (AI\/AN 0.9:100,000; 95% CI 0.6\u20131.4, White 1.1:100,000; 95% CI 1\u20131.1) compared to all ethnicities or races (Black: 0.8:100,000; 95% CI 0.7\u20130.9; Asian\/Pacific Islander: 0.4; 95% CI 0.4\u20130.5; and Hispanic: 0.6; 95% CI 0.5\u20130.6). AI\/ANs had a decreased 5-year survival rate compared to White patients (AI\/AN 59.9%; 95% CI 51.9\u201367.0% and White 67.7%; 95% CI 67.00\u201368.50%) and a higher incidence of HNC in former and current tobacco users. These findings underscore the disparities that exist in HNC for California AI\/AN populations. Future studies should aim to elucidate why the unequal burden of HNC outcomes exists, how to address increased tobacco usage, and HPV vaccination patterns to create culturally and community-based interventions.<\/jats:p>","DOI":"10.3390\/cancers13205195","type":"journal-article","created":{"date-parts":[[2021,10,17]],"date-time":"2021-10-17T23:13:32Z","timestamp":1634512412000},"page":"5195","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Head and Neck Cancer among American Indian and Alaska Native Populations in California, 2009\u20132018"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7780-9452","authenticated-orcid":false,"given":"Brooke R.","family":"Warren","sequence":"first","affiliation":[{"name":"School of Medicine, University of California, San Francisco, CA 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer R.","family":"Grandis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, San Francisco, CA 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel E.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, University of California, San Francisco, CA 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Villa","sequence":"additional","affiliation":[{"name":"Department of Orofacial Sciences, University of California, San Francisco, CA 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,16]]},"reference":[{"key":"ref_1","unstructured":"(2021, July 07). 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