Project Leader:  Dr. Matthew Olnes | Alaska Native Tribal Health Consortium

Abstract

Cancer is the leading cause of death in Alaska Native People. Significant health disparities exist in both incidence and mortality between AN people and the U.S. whites. Nasopharyngeal cancer (NPC) is the leading cancer disparity among AN people, with an incidence rate 17.3 times higher (2009-2013) and a mortality rate 21 times higher (1992-2011) than those in U.S. whites. Furthermore, NPC exhibits striking differences in incidence by age, with AN people diagnosed significantly younger ages than U.S. whites; by sex, males more commonly diagnosed than females; and by variances in tribal regions, with the highest incidence in the Inupiaq people of Northern Alaska. While disparities in NPC incidence and mortality have been well described, th etiologic basis for these disparities has not been studied systematically. 

Hypothesis

A systematic characterization of the clinical and pathologic features, patterns of care and clinical outcomes of AN patients with NPC will identify predictors for response to therapies, create and evidence-based standardized treatment approach, and generate a database that can be utilized for future translational clinical studies.

Specific Aims

  1. Create a statewide database of AN patients with NPC. An Alaska Native NPC patient database will be derived from the Alaska Native Tumor Registry and Alaska Native Medical Center Tumor Registry, electronic patient record reviews, and clinical pathology and genetic testing results.
  2. Systematically describe AN NPC patient patterns of care and assess clinical outcomes following radiation and chemotherapy regimens. Clinical data collected from patient history information and the AN NPC database will be utilized to evaluate treatment regimens, efficacy and outcomes.
  3. Determine whether baseline clinical and pathologic features correlate with clinical responses to current NPC treatment regimens. Clinical and pathological data will be correlated with patient outcomes to identify potential biomarkers associated with overall survival and that have the potential to be used for targeted therapy, information that is pertinent to understanding and treating NPC across al ethnic backgrounds.