Gopalani Sameer Vali, Janitz Amanda E, Campbell Janis E
Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States.
Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States.
Cancer Epidemiol. 2018 Oct;56:140-145. doi: 10.1016/j.canep.2018.08.008. Epub 2018 Sep 1.
The twin prevention strategies of HPV vaccination and cervical cancer screening reduce new cases and averts deaths, yet women still develop or die from cervical cancer. To assess and better understand the burden of cervical cancer in Oklahoma, we analyzed incidence and mortality trends in Oklahoma from 1999 to 2013.
We obtained age-adjusted cervical cancer incidence and mortality rates and calculated standardized rate ratios (RR) for women in Oklahoma compared to the US. To evaluate temporal changes in annual age-adjusted incidence and mortality, we calculated the annual percent change (APC) using the Joinpoint Regression Program.
We observed higher age-adjusted incidence (RR: 1.2; 95% CI: 1.1, 1.3) and mortality (RR: 1.2; 95% CI: 1.1, 1.2) rates among women in Oklahoma compared to the US. The overall incidence and mortality rates in Oklahoma were 9.7 and 2.9 per 100,000 women, respectively. In Oklahoma, the highest age-adjusted incidence rates were in American Indian/Alaska Native (AI/AN) (14.8 per 100,000 females) and Asian or Pacific Islander (API) (11.7 per 100,000 females) women and the highest mortality rates were in AI/AN (4.5 per 100,000 females) and African American (AA) (3.9 per 100,000 females) women. Incidence rates decreased for AA women (APC: -4.0; 95% CI: -7.7, -0.2), but were stable for all other races and ethnicities in Oklahoma (APC: -0.8; 95% CI: -2.2, 0.7). A stable trend for mortality was observed in Oklahoma (APC: 0.1; 95% CI: -2.2, 2.5) each year.
Women in Oklahoma had a higher cervical cancer incidence and mortality rate than the US. A disproportionately higher incidence of cervical cancer among AI/AN and API women and deaths among AI/AN and AA women were observed signaling continuing racial disparities.
人乳头瘤病毒（HPV）疫苗接种和宫颈癌筛查这两项预防策略可减少新发病例并避免死亡，但仍有女性会罹患宫颈癌或死于该病。为评估并更好地了解俄克拉何马州宫颈癌的负担，我们分析了该州1999年至2013年的发病率和死亡率趋势。
我们获取了年龄调整后的宫颈癌发病率和死亡率，并计算了俄克拉何马州女性与美国女性相比的标准化率比（RR）。为评估年度年龄调整发病率和死亡率随时间的变化，我们使用Joinpoint回归程序计算了年度百分比变化（APC）。
我们观察到，与美国女性相比，俄克拉何马州女性的年龄调整发病率（RR：1.2；95%置信区间：1.1，1.3）和死亡率（RR：1.2；95%置信区间：1.1，1.2）更高。俄克拉何马州的总体发病率和死亡率分别为每10万名女性9.7例和2.9例。在俄克拉何马州，年龄调整发病率最高的是美国印第安人/阿拉斯加原住民（AI/AN）（每10万名女性中有14.8例）和亚裔或太平洋岛民（API）（每10万名女性中有11.7例）女性，死亡率最高的是AI/AN（每10万名女性中有4.5例）和非裔美国（AA）女性（每10万名女性中有3.9例）。AA女性的发病率有所下降（APC：-4.0；95%置信区间：-7.7，-0.2），但俄克拉何马州所有其他种族和族裔的发病率保持稳定（APC：-0.8；95%置信区间：-2.2，0.7）。俄克拉何马州每年的死亡率呈稳定趋势（APC：0.1；95%置信区间：-2.2，2.5）。
俄克拉何马州女性的宫颈癌发病率和死亡率高于美国。观察到AI/AN和API女性的宫颈癌发病率以及AI/AN和AA女性的死亡率异常偏高，这表明种族差异依然存在。
