Abstract
Objective
To present more accurate incidence rates of cervical, uterine, and ovarian cancer by geographic region in American Indian/Alaska Native (AI/AN) women.
Methods
The authors used data from central cancer registries linked to Indian Health Service (IHS) patient registration database, the Behavioral Risk Factor Surveillance System, IHS National Data Warehouse, and the National Hospital Discharge Survey. Cancer incidence rates were adjusted for hysterectomy and oophorectomy prevalence and presented by region for non-Hispanic White (NHW) and AI/AN women.
Results
AI/AN women had a higher prevalence of hysterectomy (23.1%) compared with NHW women (20.9%). Correcting cancer rates for population-at-risk significantly increased the cancer incidence rates among AI/AN women: 43% for cervical cancer, 67% for uterine cancer, and 37% for ovarian cancer. Risk-correction led to increased differences in cervical cancer incidence between AI/AN and NHW women in certain regions.
Conclusions
Current reporting of cervical, uterine, and ovarian cancer underestimates the incidence in women at risk and can affect the measure of cancer disparities. Improved cancer surveillance using methodology to correct for population-at-risk may better inform disease control priorities for AI/AN populations.
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Acknowledgments
We would like to thank Harland Austin for his assistance in the statistical analysis. We also thank Annie Fair, Diana Redwood, Marty Slattery, and Alan Waxman for their contributions. Charlene Wong worked on this project during her one-year fellowship The CDC Experience, a public/private partnership supported by a grant to the CDC Foundation from External Medical Affairs, Pfizer Inc.
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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Indian Health Service.
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Wong, C.A., Jim, M.A., King, J. et al. Impact of hysterectomy and bilateral oophorectomy prevalence on rates of cervical, uterine, and ovarian cancer among American Indian and Alaska Native women, 1999–2004. Cancer Causes Control 22, 1681–1689 (2011). https://doi.org/10.1007/s10552-011-9844-2
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DOI: https://doi.org/10.1007/s10552-011-9844-2