Measuring the health status gap for American Indians Alaska natives: Getting closer to the truth
Measuring the health status gap for American Indians Alaska natives: Getting closer to the truth
复制标题
DOI：
10.2105/ajph.2004.053769
复制
发表时间：
2005-05-01
影响因子：
12.7
通讯作者：
Becker, TM
中科院分区：
文献类型：
--
作者：
Puukka, E;Stehr-Green, P;Becker, TM
目标。我们比较了计算癌症发病率的历史方法和两种新方法，以确定哪种方法最能估计西北美洲印第安人/阿拉斯加原住民（AIAN）人群的癌症负担。第一种方法复制了计算种族特异性发病率的传统方法，两种新方法使用概率记录联系来确定癌症病例。我们将所有的比率间接地调整为2000年美国人口的标准。尽管所有种族的历史癌症发病率是亚裔人口的两倍多，但当将所有种族的发病率与用概率关联方法计算的亚裔特定发病率相比时，这种明显的差距要小得多。同样，在某些特定部位和性别的癌症发病率上，AIAN人群与所有种族的发病率并无显著差异，事实上，某些发病率在AIAN人群中可能更高。我们的研究结果表明，亚洲人口的癌症负担比以前所了解的要高得多。我们建议采用一种基于概率联系方法的标准化方法，并提供足够的财政和技术支持，以便在整个印第安社区开展常规的联系研究。
Objectives. We compared the historical method of calculating cancer incidence rates with 2 new methods to determine which approach optimally estimates the burden of cancer among the Northwest American Indian/Alaska Native (AIAN) population.Methods. The first method replicates the traditional way of calculating race-specific rates, and the 2 new methods use probabilistic record linkages to ascertain cancer cases. We indirectly adjusted all rates to the standard 2000 US population.Results. Whereas the historical cancer incidence rates for all races are more than double those for the AIAN population, this apparent gap is considerably narrower when the all-race rates are compared with AIAN-specific rates calculated with probabilistic linkage methods. Similarly, there is no meaningful difference in incidence rates for selected site- and gender-specific cancers between the AIAN population and all races combined, and, in fact, some of these rates may be higher among the AIAN population.Conclusions. Our results suggest that the burden of cancer among the AIAN population is considerably higher than was previously understood. We recommend that a standardized approach based on probabilistic linkage methods be adopted and that adequate financial and technical support be made available for conducting routine linkage studies throughout Indian communities.