Cervical cancer incidence and mortality among American Indian and Alaska Native women, 1999-2009

Am J Public Health. 2014 Jun;104 Suppl 3(Suppl 3):S415-22. doi: 10.2105/AJPH.2013.301681. Epub 2014 Apr 22.

Abstract

Objectives: We analyzed cervical cancer incidence and mortality data in American Indian and Alaska Native (AI/AN) women compared with women of other races.

Methods: We improved identification of AI/AN race, cervical cancer incidence, and mortality data using Indian Health Service (IHS) patient records; our analyses focused on residents of IHS Contract Health Service Delivery Area (CHSDA) counties. Age-adjusted incidence and death rates were calculated for AI/AN and White women from 1999 to 2009.

Results: AI/AN women in CHSDA counties had a death rate from cervical cancer of 4.2, which was nearly twice the rate in White women (2.0; rate ratio [RR] = 2.11). AI/AN women also had higher incidence rates of cervical cancer compared with White women (11.0 vs 7.1; RR = 1.55) and were more often diagnosed with later-stage disease (RR = 1.84 for regional stage and RR = 1.74 for distant stage). Death rates decreased for AI/AN women from 1990 to 1993 (-25.8%/year) and remained stable thereafter.

Conclusions: Although rates decreased over time, AI/AN women had disproportionately higher cervical cancer incidence and mortality. The persistently higher rates among AI/AN women compared with White women require continued improvements in identifying and treating cervical cancer and precancerous lesions.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alaska / epidemiology
  • Alaska / ethnology
  • Cause of Death
  • Death Certificates
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Humans
  • Incidence
  • Indians, North American / statistics & numerical data*
  • Inuits / statistics & numerical data*
  • Middle Aged
  • Population Surveillance
  • Registries
  • United States / epidemiology
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / ethnology
  • Uterine Cervical Neoplasms / mortality