Nutting P A, Freeman W L, Risser D R, Helgerson S D, Paisano R, Hisnanick J, Beaver S K, Peters I, Carney J P, Speers M A
Ambulatory Sentinel Practice Network, University of Colorado Health Sciences Center, Denver 80220.
Am J Public Health. 1993 Nov;83(11):1589-98. doi: 10.2105/ajph.83.11.1589.
This study uses Indian Health Service inpatient data to estimate cancer incidence among American Indians and Alaska Natives.
Hospital discharge data for 1980 through 1987 were used to identify cases of cancer for 21 sites in women and 18 sites in men. Estimates of incidence were directly standardized to data from the Surveillance, Epidemiology, and End Results Program for the same time frame.
Cancers of the gallbladder, kidney, stomach, and cervix show generally high rates among many American Indian and Alaska Native communities, and cancers of the liver and nasopharynx are high in Alaska. Of the relatively common cancers in Whites, American Indians and Alaska Natives experience lower rates for cancers of the breast, uterus, ovaries, prostate, lung, colon, rectum, and urinary bladder and for leukemia and melanoma. Variation among geographic areas and among tribal groups is observed for many important cancer sites.
This study demonstrates significant variations of cancer rates among American Indians and Alaska Natives, with important implications for Indian Health Service cancer control programs. The study also supports the potential use of hospital discharge data for estimating chronic disease among diverse American Indian and Alaska Native communities.
本研究利用印第安卫生服务局的住院患者数据来估算美国印第安人和阿拉斯加原住民的癌症发病率。
使用1980年至1987年的医院出院数据来确定女性21个部位和男性18个部位的癌症病例。发病率估计值直接标准化为同一时间框架内监测、流行病学和最终结果计划的数据。
在许多美国印第安人和阿拉斯加原住民社区中，胆囊癌、肾癌、胃癌和宫颈癌的发病率普遍较高，阿拉斯加的肝癌和鼻咽癌发病率较高。在白人中相对常见的癌症中，美国印第安人和阿拉斯加原住民患乳腺癌、子宫癌、卵巢癌、前列腺癌、肺癌、结肠癌、直肠癌和膀胱癌以及白血病和黑色素瘤的发病率较低。许多重要癌症部位在地理区域和部落群体之间存在差异。
本研究表明美国印第安人和阿拉斯加原住民的癌症发病率存在显著差异，这对印第安卫生服务局的癌症控制项目具有重要意义。该研究还支持利用医院出院数据来估算不同美国印第安人和阿拉斯加原住民社区的慢性病情况。
