Hoopes Megan J, Petersen Paneen, Vinson Eric, Lopez Kerri
Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, 2121 SW Broadway Drive, Suite 300, Portland, OR 97201, USA.
J Cancer Educ. 2012 Apr;27(1 Suppl):S73-9. doi: 10.1007/s13187-012-0325-4.
In the Pacific Northwest, cancer is a leading cause of morbidity and mortality for American Indians and Alaska Natives (AI/AN). Misclassification of AI/AN race in state cancer registries causes cancer burden to be underestimated. Furthermore, local-level data are rarely available to individual tribes for use in health assessment and program planning. We corrected race coding in the cancer registries of Idaho, Oregon, and Washington using probabilistic record linkage to a file derived from patient registration records from Indian Health Service and a large urban clinic. We calculated cancer incidence and mortality measures by state, comparing AI/AN to non-Hispanic White (NHW) race. Record linkages identified a high prevalence of misclassified race. Differences in AI/AN cancer patterns were identified across the three state region. Compared to NHW, AI/AN experienced disproportionate late stage rates of some screen-detectable cancers. The correct classification of race is a crucial factor in cancer surveillance and can reveal regional differences even within a relatively small area. The availability of local-level cancer data can help inform tribes in appropriate intervention efforts.
在太平洋西北地区，癌症是美国印第安人和阿拉斯加原住民（AI/AN）发病和死亡的主要原因。州癌症登记处对AI/AN种族的错误分类导致癌症负担被低估。此外，各个部落很少能获得地方层面的数据用于健康评估和项目规划。我们利用概率性记录链接，将爱达荷州、俄勒冈州和华盛顿州癌症登记处的种族编码与一份源自印第安卫生服务机构和一家大型城市诊所患者登记记录的文件进行了校正。我们按州计算了癌症发病率和死亡率指标，将AI/AN种族与非西班牙裔白人（NHW）种族进行了比较。记录链接发现种族误分类的情况很普遍。在这三个州的区域内，AI/AN癌症模式存在差异。与NHW相比，AI/AN某些可筛查癌症的晚期发病率过高。种族的正确分类是癌症监测的关键因素，甚至在相对较小的区域内也能揭示区域差异。地方层面癌症数据的可得性有助于为部落的适当干预措施提供信息。
