Bleed D M, Risser D R, Sperry S, Hellhake D, Helgerson S D
Indian Health Service, Billings, Mont.
J Natl Cancer Inst. 1992 Oct 7;84(19):1500-5. doi: 10.1093/jnci/84.19.1500.
Cancer incidence and cancer survival estimates in American Indians are quite limited.
Our purpose was to estimate cancer incidence and survival in American Indians who were registered for Indian Health Service (IHS) care in Montana.
We linked databases from the IHS and the Montana Central Tumor Registry (MCTR) to ascertain cases for the time period from January 1, 1982, through December 31, 1987. To calculate survival rates, we used a relative survival method that incorporated age-specific risks for noncancer deaths among American Indians.
We identified 344 cases that were compatible with the National Cancer Institute (Surveillance, Epidemiology, and End Results Program) surveillance definition of cancer. Of these cases, 249 (72%) were listed in both the MCTR and the IHS databases; 56 (16%) and 39 (11%) were listed in only the MCTR or the IHS database, respectively. Compared with the overall cancer incidence in U.S. White men, the overall cancer incidence in Montana American Indian men was markedly lower, as was the incidence for colorectal and bladder cancers and for non-Hodgkin's lymphoma. The overall cancer incidence for Montana American Indian women differed less markedly, however, from the overall incidence in U.S. White women. Compared with the cancer incidence in U.S. White women, the incidence in Montana American Indian women was significantly higher for cervical cancer but was significantly lower for colorectal, breast, and uterine cancers. Survival rates from cancer were also examined for the first time in this population. For those sites examined, the survival rates were much lower in Montana American Indians than in U.S. Whites.
We conclude that it is feasible to develop state-specific cancer incidence and survival estimates for American Indians in at least some states in different regions of the United States. Collaboration between the IHS and a state tumor registry is likely to improve the case ascertainment achieved by either agency alone.
关于美国印第安人的癌症发病率和癌症生存率的估计相当有限。
我们的目的是估计在蒙大拿州登记接受印第安卫生服务（IHS）护理的美国印第安人的癌症发病率和生存率。
我们将IHS和蒙大拿州中央肿瘤登记处（MCTR）的数据库相链接，以确定1982年1月1日至1987年12月31日期间的病例。为了计算生存率，我们使用了一种相对生存方法，该方法纳入了美国印第安人中非癌症死亡的年龄特异性风险。
我们确定了344例符合美国国立癌症研究所（监测、流行病学和最终结果计划）癌症监测定义的病例。在这些病例中，249例（72%）同时列于MCTR和IHS数据库；56例（16%）和39例（11%）分别仅列于MCTR或IHS数据库。与美国白人男性的总体癌症发病率相比，蒙大拿州美国印第安男性的总体癌症发病率明显较低，结直肠癌、膀胱癌和非霍奇金淋巴瘤的发病率也是如此。然而，蒙大拿州美国印第安女性的总体癌症发病率与美国白人女性的总体发病率差异不太明显。与美国白人女性的癌症发病率相比，蒙大拿州美国印第安女性宫颈癌的发病率显著较高，但结直肠癌、乳腺癌和子宫癌的发病率显著较低。该人群中癌症生存率也首次得到了研究。在所研究的那些部位，蒙大拿州美国印第安人的生存率远低于美国白人。
我们得出结论，在美国不同地区的至少一些州，为美国印第安人制定特定州的癌症发病率和生存率估计是可行的。IHS与州肿瘤登记处之间的合作可能会改善任一机构单独实现的病例确定情况。
