David G. Perdue is with the American Indian Cancer Foundation, and Minnesota Gastroenterology PA, Minneapolis. Donald Haverkamp is with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Carin Perkins is with the Minnesota Cancer Surveillance System, Minneapolis. Christine Makosky Daley is with the Center for American Indian Community Health, University of Kansas Medical Center, Kansas City. Ellen Provost is with the Alaska Native Tribal Health Consortium, Anchorage.
Am J Public Health. 2014 Jun;104 Suppl 3(Suppl 3):S404-14. doi: 10.2105/AJPH.2013.301654. Epub 2014 Apr 22.
We characterized estimates of colorectal cancer (CRC) in American Indians/Alaska Natives (AI/ANs) compared with Whites using a linkage methodology to improve AI/AN classification in incidence and mortality data.
We linked incidence and mortality data to Indian Health Service enrollment records. Our analyses were restricted to Contract Health Services Delivery Area counties. We analyzed death and incidence rates of CRC for AI/AN persons and Whites by 6 regions from 1999 to 2009. Trends were described using linear modeling.
The AI/AN colorectal cancer incidence was 21% higher and mortality 39% higher than in Whites. Although incidence and mortality significantly declined among Whites, AI/AN incidence did not change significantly, and mortality declined only in the Northern Plains. AI/AN persons had a higher incidence of CRC than Whites in all ages and were more often diagnosed with late stage CRC than Whites.
Compared with Whites, AI/AN individuals in many regions had a higher burden of CRC and stable or increasing CRC mortality. An understanding of the factors driving these regional disparities could offer critical insights for prevention and control programs.
我们采用链接方法对美国印第安人/阿拉斯加原住民（AI/AN）与白人的结直肠癌（CRC）进行了比较，以改善发病率和死亡率数据中 AI/AN 的分类。
我们将发病率和死亡率数据与印第安卫生服务登记记录进行了链接。我们的分析仅限于合同医疗服务提供地区的县。我们分析了 1999 年至 2009 年来自 6 个地区的 AI/AN 人群和白人的 CRC 死亡和发病率。使用线性模型描述趋势。
AI/AN 的结直肠癌发病率比白人高 21%，死亡率高 39%。尽管白人的发病率和死亡率显著下降，但 AI/AN 的发病率并没有显著变化，死亡率仅在大平原地区有所下降。在所有年龄段，AI/AN 人群的 CRC 发病率均高于白人，并且比白人更常被诊断为晚期 CRC。
与白人相比，许多地区的 AI/AN 个体 CRC 负担更重，CRC 死亡率稳定或上升。了解推动这些地区差异的因素可能为预防和控制计划提供关键的见解。
