Cancer among American Indians and Alaska Natives in the United States, 1999-2004
Cancer among American Indians and Alaska Natives in the United States, 1999-2004
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DOI：
10.1002/cncr.23734
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发表时间：
2008-09-01
期刊：
影响因子：
6.2
通讯作者：
Lanier, Anne P.
中科院分区：
文献类型：
--
作者：
Wiggins, Charles L.;Espey, David K.;Lanier, Anne P.
背景。美洲印第安人和阿拉斯加原住民 (AI/AN) 人群的癌症发病率有所不同，并且通常与非西班牙裔白人 (NHW) 的癌症发病率不同。然而，中央癌症登记处对 AI/AN 癌症病例种族的错误分类可能导致之前报告中对 AI/AN 癌症负担的低估。 1999 年至 2004 年期间诊断的病例是从美国基于人群的癌症登记处确定的。计算了 25 个最常见的 AI/AN 和 NHW 站点的年龄调整率。为了最大限度地减少种族错误分类，癌症登记记录与印度卫生服务 (IHS) 的患者登记文件相关联。分析仅限于合同医疗服务提供区 (CHSDA) 县，并按 IHS 区域进行分层。 结果。在 CHSDA 县中，AI/AN 的癌症发病率因地区而异，而 NHW 的癌症发病率则没有差异。对于所有癌症部位的总和，北部和南部平原的男性和女性以及阿拉斯加原住民女性的 AI/AN 率均高于 NHW 率；西南部、太平洋沿岸和法斯特地区的 AI/AN 率低于 NHW 率。在阿拉斯加和北部平原，AI/AN 的肺癌和结直肠癌发病率超过了 NHW 的发病率。在阿拉斯加、平原地区和西南部，AI/AN 中胃癌、胆囊癌、肾癌和肝癌的总体发病率高于 NHW。结论。从全国数据来看，AI/AN 人群癌症发病率的区域差异并不明显，这凸显了癌症控制和预防的机会。这种差异不太可能用人脸错误分类来解释。
BACKGROUND. Cancer incidence rates vary among American Indian and Alaska Native (AI/AN) populations and often differ from rates among non-Hispanic whites (NHWs). However, the misclassification of race for AI/AN cancer cases in central cancer registries may have led to underestimates of the AI/AN cancer burden in previous reports.METHODS. Cases diagnosed during 1999 through 2004 were identified from population-based cancer registries in the United States. Age-adjusted rates were calculated for the 25 most common sites for AI/ANs and NHWs. To minimize the misclassification of race, cancer registry records were linked with patient registration files from the Indian Health Service (IHS). Analyses were restricted to Contract Health Service Delivery Area (CHSDA) Counties and were stratified by IHS region.RESULTS. In CHSDA counties, cancer incidence rates among AI/ANs varied widely by region, whereas rates among NHWs did not. For all cancer sites combined, AI/AN rates were higher than NHW rates among both males and females in the Northern and Southern Plains, and among Alaska Native Females; AI/AN rates were lower than NHW rates in the Southwest, the Pacific Coast, and the Fast. Lung cancer and colorectal cancer rates for AI/ANs exceeded rates for NHWs in Alaska and the Northern Plains. Rates for stomach, gallbladder, kidney, and liver cancer were higher among AI/ANs than among NHWs overall, in Alaska, in the Plains regions, and in the Southwest.CONCLUSIONS. Regional differences in cancer incidence rates among AI/AN Populations were not obvious from nationwide data and highlighted opportunities for cancer control and prevention. It is unlikely that such differences are explained by Face misclassification.