Breast Cancer Mortality Among American Indian and Alaska Native Women, 1990-2009
Breast Cancer Mortality Among American Indian and Alaska Native Women, 1990-2009
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DOI：
10.2105/ajph.2013.301720
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发表时间：
2014-06-01
影响因子：
12.7
通讯作者：
Kaur, Judith S.
中科院分区：
文献类型：
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作者：
White, Arica;Richardson, Lisa C.;Kaur, Judith S.
目标.我们比较了美国印第安人/阿拉斯加原住民（AI/AN）和白色妇女的乳腺癌死亡率和死亡趋势，使用的数据是种族错误分类最小化。我们使用与印度卫生服务局（IHS）数据相关的乳腺癌死亡和病例，计算1990年至2009年AI/AN和白色妇女的IHS指定地区的年龄调整率和95%置信区间（CI）;西班牙裔被排除在外。计算1999年至2009年的死亡率与发病率的比值（MIR），作为诊断后预后的指标。总体而言，AI/AN妇女的乳腺癌死亡率（每10万人21.6例）低于白色妇女（26.5例）。然而，在阿拉斯加地区，40至49岁的AI/AN的发病率高于白人，在南部平原地区，65岁及以上的AI/AN的发病率高于白人。白色人死亡率显著降低（年变化百分比[APC] = -2.1，95% CI =-2.3，-2.0），但区域和总体AI/AN率无变化（APC = 0.9; 95% CI = 0.1，1.7）。AI/AN女性的MIRs高于白色女性。人工流产/人工流产妇女的死亡率没有改善。需要有针对性的筛查和及时、高质量的治疗，以降低AI/AN女性乳腺癌的死亡率。
Objectives. 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.