Leman Richard F, Espey David, Cobb Nathaniel
Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Rep. 2005 May-Jun;120(3):283-7. doi: 10.1177/003335490512000311.
Cervical cancer mortality rates among the American Indian and Alaska Native (AI/AN) population in North and South Dakota were five times the national average (15.6 per 100,000 vs. 3.1 per 100,000, age adjusted) when last evaluated (from 1989 through 1993). Our goals were to update the AI/AN population cervical cancer mortality rates and to present incidence rates for AI/AN women in the region.
We reviewed charts for women diagnosed with invasive cervical cancer at Indian Health Service (IHS) facilities in North and South Dakota from 1994 through 1998 and collected information about cervical cancer screening and treatment history. Incidence and mortality rates were standardized to the 1970 U.S. population.
Twenty-one cases of invasive cervical cancer and eight deaths were identified. Annualized incidence and mortality rates were 11.5 per 100,000 and 4.5 per 100,000. These compare with national all-race/ethnicity rates of 8.5 per 100,000 and 2.7 per 100,000 for incidence and mortality. Fifteen (71%) of 21 cases were diagnosed due to symptoms.
While cervical cancer mortality rates have declined, incidence and mortality rates among AI/AN women remain higher than in the general U.S. population. Increased use of pap tests and careful follow-up of abnormal results should be aggressively promoted among AI/AN women in North and South Dakota.
上次评估（1989年至1993年）时，北达科他州和南达科他州的美国印第安人和阿拉斯加原住民（AI/AN）人群的宫颈癌死亡率是全国平均水平的五倍（年龄调整后为每10万人15.6例，而全国平均水平为每10万人3.1例）。我们的目标是更新AI/AN人群的宫颈癌死亡率，并呈现该地区AI/AN女性的发病率。
我们查阅了1994年至1998年在北达科他州和南达科他州印第安卫生服务（IHS）机构被诊断为浸润性宫颈癌的女性病历，并收集了有关宫颈癌筛查和治疗史的信息。发病率和死亡率按照1970年美国人口进行标准化。
共确定了21例浸润性宫颈癌病例和8例死亡病例。年化发病率和死亡率分别为每10万人11.5例和每10万人4.5例。相比之下，全国所有种族/族裔的发病率和死亡率分别为每10万人8.5例和每10万人2.7例。21例病例中有15例（7%)因症状而被诊断。
虽然宫颈癌死亡率有所下降，但AI/AN女性的发病率和死亡率仍高于美国总体人群。应积极推动北达科他州和南达科他州的AI/AN女性增加巴氏试验的使用，并对异常结果进行仔细随访。
