Amanda S Bruegl1, Sujata Joshi2, Samantha Batman3, Mercedes Weisenberger3, Elizabeth Munro3, Thomas Becker4. 1. Department of Obstetrics and Gynecology, 3181 SW Sam Jackson Park Road, Oregon Health and Science University (OHSU), Portland, OR 97239, USA. Electronic address: bruegl@ohsu.edu. 2. Northwest Portland Area Indian Health Board Tribal Epidemiology Center, 2121 SW Broadway, Suite 300, Portland, OR 97201, USA. 3. Department of Obstetrics and Gynecology, 3181 SW Sam Jackson Park Road, Oregon Health and Science University (OHSU), Portland, OR 97239, USA. 4. Northwest Portland Area Indian Health Board Tribal Epidemiology Center, 2121 SW Broadway, Suite 300, Portland, OR 97201, USA; OHSU-Portland State University (PSU) School of Public Health, 506 SW Mill Street, Portland, OR 97201, USA.
Abstract
OBJECTIVES: Compare the incidence and mortality of gynecologic cancers among American Indian/Alaska Native (AI/AN) women to the Non-Hispanic White (NHW) population in the Pacific Northwest. METHODS: Age-adjusted cancer incidence (1996-2016) and mortality (2006-2016) rates were calculated from population-based state cancer registry and death certificate data obtained from Washington, Oregon, and Idaho, and corrected for AI/AN misclassification. Incidence and mortality rate ratios (RR) were calculated to compare AI/AN and NHW women with gynecologic cancers. RESULTS: Across all gynecologic cancer sites, AI/AN women were diagnosed at a younger age compared to NHW women. AI/AN women had a higher incidence of cervical cancer compared to NHW women with a RR of 1.53 (95% CI: 1.34, 1.75). For all age groups, AI/AN women had a higher incidence of cervical cancer and the disparity was greatest in the 50-64 age group with a RR of 1.76 (95% CI: 1.36, 2.30). Cervical cancer mortality was greater among AI/AN women, with an all-ages RR of 1.79 (95% CI: 1.30, 2.46); the disparity was greatest in the 50-64 age group (RR: 2.88, 95% CI: 1.89, 4.38). For uterine cancer, AI/AN women had similar incidence rates as NHW women but higher mortality rates (RR: 1.35, 95% CI: 1.03-1.75). Incidence and mortality for ovarian cancer were similar between groups. CONCLUSION: Our analysis of gynecologic cancers among AI/AN in the PNW found significant disparities relative to NHW women in cervical cancer incidence and mortality. These disparities persist despite advances in prevention strategies. Published by Elsevier Inc.
OBJECTIVES: Compare the incidence and mortality of gynecologic cancers among American Indian/Alaska Native (AI/AN) women to the Non-Hispanic White (NHW) population in the Pacific Northwest. METHODS: Age-adjusted cancer incidence (1996-2016) and mortality (2006-2016) rates were calculated from population-based state cancer registry and death certificate data obtained from Washington, Oregon, and Idaho, and corrected for AI/AN misclassification. Incidence and mortality rate ratios (RR) were calculated to compare AI/AN and NHW women with gynecologic cancers. RESULTS: Across all gynecologic cancer sites, AI/AN women were diagnosed at a younger age compared to NHW women. AI/AN women had a higher incidence of cervical cancer compared to NHW women with a RR of 1.53 (95% CI: 1.34, 1.75). For all age groups, AI/AN women had a higher incidence of cervical cancer and the disparity was greatest in the 50-64 age group with a RR of 1.76 (95% CI: 1.36, 2.30). Cervical cancer mortality was greater among AI/AN women, with an all-ages RR of 1.79 (95% CI: 1.30, 2.46); the disparity was greatest in the 50-64 age group (RR: 2.88, 95% CI: 1.89, 4.38). For uterine cancer, AI/AN women had similar incidence rates as NHW women but higher mortality rates (RR: 1.35, 95% CI: 1.03-1.75). Incidence and mortality for ovarian cancer were similar between groups. CONCLUSION: Our analysis of gynecologic cancers among AI/AN in the PNW found significant disparities relative to NHW women in cervical cancer incidence and mortality. These disparities persist despite advances in prevention strategies. Published by Elsevier Inc.
Entities:
Keywords:
Alaska Native; American Indian; Cervical cancer; Incidence; Mortality; Uterine cancer
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