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Comparative Study
. 2014 Jun;104 Suppl 3(Suppl 3):S432-8.
doi: 10.2105/AJPH.2013.301720. Epub 2014 Apr 22.

Breast cancer mortality among American Indian and Alaska Native women, 1990-2009

Arica White  1 , Lisa C Richardson, Chunyu Li, Donatus U Ekwueme, Judith S Kaur
Affiliations
Comparative Study

Breast cancer mortality among American Indian and Alaska Native women, 1990-2009

Arica White et al. Am J Public Health. 2014 Jun.

Erratum in

  • Am J Public Health. 2014 Aug;104(8):e6

Abstract

Objectives: We compared breast cancer death rates and mortality trends among American Indian/Alaska Native (AI/AN) and White women using data for which racial misclassification was minimized.

Methods: We used breast cancer deaths and cases linked to Indian Health Service (IHS) data to calculate age-adjusted rates and 95% confidence intervals (CIs) by IHS-designated regions from 1990 to 2009 for AI/AN and White women; Hispanics were excluded. Mortality-to-incidence ratios (MIR) were calculated for 1999 to 2009 as a proxy for prognosis after diagnosis.

Results: Overall, the breast cancer death rate was lower in AI/AN women (21.6 per 100,000) than in White women (26.5). However, rates in AI/ANs were higher than rates in Whites for ages 40 to 49 years in the Alaska region, and ages 65 years and older in the Southern Plains region. White death rates significantly decreased (annual percent change [APC] = -2.1; 95% CI = -2.3, -2.0), but regional and overall AI/AN rates were unchanged (APC = 0.9; 95% CI = 0.1, 1.7). AI/AN women had higher MIRs than White women.

Conclusions: There has been no improvement in death rates among AI/AN women. Targeted screening and timely, high-quality treatment are needed to reduce mortality from breast cancer in AI/AN women.

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Figures

FIGURE 1—
FIGURE 1—
Trends in age-adjusted breast cancer death rates using Joinpoint: Contract Health Service Delivery Area counties, all Indian Health Service regions combined, United States, 1990–2009. Note. AI/AN = American Indian/Alaska Native. Joinpoint analyses with up to 3 joinpoints are based on rates per 100 000 persons and were age-adjusted to the 2000 US standard population (19 age groups, Census P25-113019); Joinpoint (JP) Regression Program, Version 4.0.1. January 2013; Statistical Research and Applications Branch, National Cancer Institute. Source. AI/AN-US Mortality Database (AMD 1990–2009).
See this image and copyright information in PMC

References

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