Ulmer Keely K, Greteman Breanna, Gonzalez Bosquet Jesus, Petereit Daniel, Harper Diane, Nash Sarah H
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Iowa Cancer Registry, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA.
Womens Health Rep (New Rochelle). 2025 Feb 25;6(1):199-208. doi: 10.1089/whr.2024.0124. eCollection 2025.
American Indian and Alaska Native (AI/AN) women experience higher rates of mortality from many cancers than their non-Native counterparts.
To examine recent data on gynecological cancers (cervical, ovarian, and uterine) among AI/AN women living in the Upper Midwest (Iowa, Montana, Nebraska, North Dakota, South Dakota, and Wyoming) for any improvement in equity.
We used data from the North American Association for Central Cancer Registries Cancer in North America database (1995-2019). We used descriptive statistics, including incidence mortality rates, trends, and time to treatment. Analyses were restricted to non-Hispanic individuals living in a purchased/referred care delivery area (PRCDA) at the time of diagnosis; sensitivity analyses included all AI/AN people, regardless of PRCDA residence or ethnicity.
From 1995 to 2019, there were 647 gynecological cancers diagnosed among AI/AN women living in PRCDA counties in the Upper Midwest (cervical = 194, ovarian = 142, uterine = 311). Incidence and mortality rates for ovarian and uterine cancers were similar between AI/AN and non-Hispanic White (NHW) women; however, the incidence of cervical cancer was 1.87 (95% confidence interval [CI]: 1.60, 2.17) times higher, and mortality was 2.92 (95% CI: 2.29, 3.68) times higher among AI/AN compared to NHW women. The majority of AI/AN women diagnosed with gynecological cancer initiated treatment within 1 month (cervical = 67.2%, ovarian = 80.6%, uterine = 63.1%), which was similar to NHW women.
Differences exist in incidence and mortality for cervical cancer between AI/AN and NHW women in the Upper Midwest, with AI/AN facing continued inequity.
与非原住民女性相比，美国印第安人和阿拉斯加原住民（AI/AN）女性因多种癌症导致的死亡率更高。
研究居住在中西部上游地区（爱荷华州、蒙大拿州、内布拉斯加州、北达科他州、南达科他州和怀俄明州）的AI/AN女性的妇科癌症（宫颈癌、卵巢癌和子宫癌）的最新数据，以了解公平性方面是否有任何改善。
我们使用了北美中央癌症登记协会北美癌症数据库（1995 - 2019年）中的数据。我们使用了描述性统计方法，包括发病率、死亡率、趋势和治疗时间。分析仅限于诊断时居住在购买/转诊护理提供区域（PRCDA）的非西班牙裔个体；敏感性分析包括所有AI/AN人群，无论其是否居住在PRCDA地区或种族如何。
1995年至2019年期间，居住在中西部上游地区PRCDA县的AI/AN女性中诊断出647例妇科癌症（宫颈癌 = 194例，卵巢癌 = 142例，子宫癌 = 311例）。AI/AN女性与非西班牙裔白人（NHW）女性的卵巢癌和子宫癌发病率及死亡率相似；然而，与NHW女性相比，AI/AN女性的宫颈癌发病率高1.87倍（95%置信区间[CI]：1.60，2.17），死亡率高2.92倍（95%CI：2.29，3.68）。大多数被诊断患有妇科癌症的AI/AN女性在1个月内开始治疗（宫颈癌 = 67.2%，卵巢癌 = 80.6%，子宫癌 = 63.1%），这与NHW女性相似。
在中西部上游地区，AI/AN女性与NHW女性在宫颈癌的发病率和死亡率方面存在差异，AI/AN女性仍面临持续的不公平。
