Kelly Janet J, Lanier Anne P, Schade Teresa, Brantley Jennifer, Starkey B Michael
Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center, Division of Community Health Services, 3900 Ambassador Dr, Anchorage, Alaska 99508. Telephone: 907-729-3949. E-mail:
Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center, Division of Community Health Services, Anchorage, Alaska.
Prev Chronic Dis. 2014 Dec 18;11:E221. doi: 10.5888/pcd11.130369.
Cancer is the leading cause of death among Alaska Native people. The objective of this study was to examine cancer incidence data for 2007-2011, age-specific rates for a 15-year period, incidence trends for 1970-2011, and mortality trends for 1990-2011.
US data were from the Surveillance, Epidemiology, and End Results (SEER) Program SEER*Stat database and from the SEER Alaska Native Tumor Registry. Age-adjusted cancer incidence rates among Alaska Native people and US whites were compared using rate ratios. Trend analyses were performed using the Joinpoint Regression Program. Mortality data were from National Center for Health Statistics.
During 2007-2011 the cancer incidence rate among Alaska Native women was 16% higher than the rate among US white women and was similar among Alaska Native men and US white men. Incidence rates among Alaska Native people exceeded rates among US whites for nasopharyngeal, stomach, colorectal, lung, and kidney cancer. A downward trend in colorectal cancer incidence among Alaska Native people occurred from 1999 to 2011. Significant declines in rates were not observed for other frequently diagnosed cancers or for all sites combined. Cancer mortality rates among Alaska Native people during 2 periods, 1990-2000 and 2001-2011, did not decline. Cancer mortality rates among Alaska Native people exceeded rates among US whites for all cancers combined; for cancers of the lung, stomach, pancreas, kidney, and cervix; and for colorectal cancer.
Increases in colorectal screening among Alaska Native people may be responsible for current declines in colorectal cancer incidence; however; improvements in treatment of colon and rectal cancers may also be contributing factors.
癌症是阿拉斯加原住民的主要死因。本研究的目的是检查2007 - 2011年的癌症发病率数据、15年期间的年龄别发病率、1970 - 2011年的发病率趋势以及1990 - 2011年的死亡率趋势。
美国的数据来自监测、流行病学和最终结果(SEER)计划的SEER*Stat数据库以及SEER阿拉斯加原住民肿瘤登记处。使用率比比较阿拉斯加原住民和美国白人的年龄调整癌症发病率。使用Joinpoint回归程序进行趋势分析。死亡率数据来自国家卫生统计中心。
在2007 - 2011年期间,阿拉斯加原住民女性的癌症发病率比美国白人女性高16%,阿拉斯加原住民男性和美国白人男性的发病率相似。阿拉斯加原住民的鼻咽癌、胃癌、结直肠癌、肺癌和肾癌发病率超过美国白人。1999年至2011年,阿拉斯加原住民的结直肠癌发病率呈下降趋势。其他常见诊断癌症或所有部位综合发病率均未观察到显著下降。在1990 - 2000年和2001 - 2011年这两个时期,阿拉斯加原住民的癌症死亡率没有下降。阿拉斯加原住民的所有癌症综合死亡率、肺癌、胃癌、胰腺癌、肾癌和宫颈癌以及结直肠癌的死亡率均超过美国白人。
阿拉斯加原住民结直肠癌筛查的增加可能是目前结直肠癌发病率下降的原因;然而,结肠癌和直肠癌治疗的改善也可能是促成因素。