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Breast cancer mortality among American Indian and Alaska Native women, 1990-2009

TitleBreast cancer mortality among American Indian and Alaska Native women, 1990-2009
Publication TypeJournal Article
Year of Publication2014
AuthorsWhite, A, Richardson, LC, Li, C, Ekwueme, DU, Kaur, JS
JournalAm J Public HealthAm J Public Health
Volume104 Suppl 3
PaginationS432-8
Date PublishedJun
ISBN Number1541-0048 (Electronic)<br/>0090-0036 (Linking)
Accession Number24754658
KeywordsAdult, Aged, Aged, 80 and Over, Alaska/epidemiology/ethnology, Breast Neoplasms/ epidemiology/ethnology/mortality, Cause of Death, Death Certificates, European Continental Ancestry Group/statistics & numerical data, Female, Humans, Incidence, Indians, North American/ statistics & numerical data, Inuits/ statistics & numerical data, Middle Aged, Population Surveillance, Registries, United States/epidemiology
AbstractOBJECTIVES: We compared breast cancer death rates and mortality trends among American Indian/Alaska Native (AI/AN) and White women using data for which racial misclassification was minimized. METHODS: We used breast cancer deaths and cases linked to Indian Health Service (IHS) data to calculate age-adjusted rates and 95% confidence intervals (CIs) by IHS-designated regions from 1990 to 2009 for AI/AN and White women; Hispanics were excluded. Mortality-to-incidence ratios (MIR) were calculated for 1999 to 2009 as a proxy for prognosis after diagnosis. RESULTS: Overall, the breast cancer death rate was lower in AI/AN women (21.6 per 100,000) than in White women (26.5). However, rates in AI/ANs were higher than rates in Whites for ages 40 to 49 years in the Alaska region, and ages 65 years and older in the Southern Plains region. White death rates significantly decreased (annual percent change [APC] = -2.1; 95% CI = -2.3, -2.0), but regional and overall AI/AN rates were unchanged (APC = 0.9; 95% CI = 0.1, 1.7). AI/AN women had higher MIRs than White women. CONCLUSIONS: There has been no improvement in death rates among AI/AN women. Targeted screening and timely, high-quality treatment are needed to reduce mortality from breast cancer in AI/AN women.
Ethno Med: