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Cervical cancer incidence and mortality among American Indian and Alaska Native women, 1999-2009

TitleCervical cancer incidence and mortality among American Indian and Alaska Native women, 1999-2009
Publication TypeJournal Article
Year of Publication2014
AuthorsWatson, M, Benard, V, Thomas, C, Brayboy, A, Paisano, R, Becker, T
JournalAm J Public HealthAm J Public Health
Volume104 Suppl 3
PaginationS415-22
Date PublishedJun
ISBN Number1541-0048 (Electronic)<br/>0090-0036 (Linking)
Accession Number24754650
KeywordsAdult, Aged, Aged, 80 and Over, Alaska/epidemiology/ethnology, 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, Uterine Cervical Neoplasms/ epidemiology/ethnology/mortality
AbstractOBJECTIVES: We analyzed cervical cancer incidence and mortality data in American Indian and Alaska Native (AI/AN) women compared with women of other races. METHODS: We improved identification of AI/AN race, cervical cancer incidence, and mortality data using Indian Health Service (IHS) patient records; our analyses focused on residents of IHS Contract Health Service Delivery Area (CHSDA) counties. Age-adjusted incidence and death rates were calculated for AI/AN and White women from 1999 to 2009. RESULTS: AI/AN women in CHSDA counties had a death rate from cervical cancer of 4.2, which was nearly twice the rate in White women (2.0; rate ratio [RR] = 2.11). AI/AN women also had higher incidence rates of cervical cancer compared with White women (11.0 vs 7.1; RR = 1.55) and were more often diagnosed with later-stage disease (RR = 1.84 for regional stage and RR = 1.74 for distant stage). Death rates decreased for AI/AN women from 1990 to 1993 (-25.8%/year) and remained stable thereafter. CONCLUSIONS: Although rates decreased over time, AI/AN women had disproportionately higher cervical cancer incidence and mortality. The persistently higher rates among AI/AN women compared with White women require continued improvements in identifying and treating cervical cancer and precancerous lesions.
Ethno Med: