Cancer Causes & Control

, 22:1681 | Cite as

Impact of hysterectomy and bilateral oophorectomy prevalence on rates of cervical, uterine, and ovarian cancer among American Indian and Alaska Native women, 1999–2004

  • Charlene A. Wong
  • Melissa A. Jim
  • Jessica King
  • Lillian Tom-Orme
  • Jeffrey A. Henderson
  • Mona Saraiya
  • Lisa C. Richardson
  • Larry Layne
  • Anil Suryaprasad
  • David K. Espey
Original paper



To present more accurate incidence rates of cervical, uterine, and ovarian cancer by geographic region in American Indian/Alaska Native (AI/AN) women.


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.


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.


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.


Hysterectomy American Indian/Alaska Native Cervical cancer Incidence 


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Copyright information

© Springer Science+Business Media B.V. (outside the USA)  2011

Authors and Affiliations

  • Charlene A. Wong
    • 1
  • Melissa A. Jim
    • 1
    • 2
  • Jessica King
    • 1
  • Lillian Tom-Orme
    • 3
  • Jeffrey A. Henderson
    • 4
  • Mona Saraiya
    • 1
  • Lisa C. Richardson
    • 1
  • Larry Layne
    • 2
  • Anil Suryaprasad
    • 1
  • David K. Espey
    • 1
    • 5
  1. 1.Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters of Disease Control and PreventionAtlantaUSA
  2. 2.Division of Epidemiology and Disease PreventionIndian Health ServiceAlbuquerqueUSA
  3. 3.University of UtahSalt Lake CityUSA
  4. 4.Black Hills Center for American Indian HealthRapid CityUSA
  5. 5.Division of Cancer Prevention and ControlCenters for Disease Prevention and ControlAlbuquerqueUSA

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