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Impact of hysterectomy and bilateral oophorectomy prevalence on rates of cervical, uterine, and ovarian cancer among American Indian and Alaska Native women, 1999–2004

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Abstract

Objective

To present more accurate incidence rates of cervical, uterine, and ovarian cancer by geographic region in American Indian/Alaska Native (AI/AN) women.

Methods

The authors used data from central cancer registries linked to Indian Health Service (IHS) patient registration database, the Behavioral Risk Factor Surveillance System, IHS National Data Warehouse, and the National Hospital Discharge Survey. Cancer incidence rates were adjusted for hysterectomy and oophorectomy prevalence and presented by region for non-Hispanic White (NHW) and AI/AN women.

Results

AI/AN women had a higher prevalence of hysterectomy (23.1%) compared with NHW women (20.9%). Correcting cancer rates for population-at-risk significantly increased the cancer incidence rates among AI/AN women: 43% for cervical cancer, 67% for uterine cancer, and 37% for ovarian cancer. Risk-correction led to increased differences in cervical cancer incidence between AI/AN and NHW women in certain regions.

Conclusions

Current reporting of cervical, uterine, and ovarian cancer underestimates the incidence in women at risk and can affect the measure of cancer disparities. Improved cancer surveillance using methodology to correct for population-at-risk may better inform disease control priorities for AI/AN populations.

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Acknowledgments

We would like to thank Harland Austin for his assistance in the statistical analysis. We also thank Annie Fair, Diana Redwood, Marty Slattery, and Alan Waxman for their contributions. Charlene Wong worked on this project during her one-year fellowship The CDC Experience, a public/private partnership supported by a grant to the CDC Foundation from External Medical Affairs, Pfizer Inc.

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Authors and Affiliations

  1. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention, Atlanta, GA, USA

    Charlene A. Wong, Melissa A. Jim, Jessica King, Mona Saraiya, Lisa C. Richardson, Anil Suryaprasad & David K. Espey

  2. Division of Epidemiology and Disease Prevention, Indian Health Service, Albuquerque, NM, USA

    Melissa A. Jim & Larry Layne

  3. University of Utah, Salt Lake City, UT, USA

    Lillian Tom-Orme

  4. Black Hills Center for American Indian Health, Rapid City, SD, USA

    Jeffrey A. Henderson

  5. Division of Cancer Prevention and Control, Centers for Disease Prevention and Control, c/o Indian Health Service Division of Epidemiology and Disease Prevention, 5300 Homestead Rd NE, Albuquerque, NM, 87110, USA

    David K. Espey

Authors
  1. Charlene A. Wong
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  2. Melissa A. Jim
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  7. Lisa C. Richardson
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  10. David K. Espey
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Corresponding author

Correspondence to David K. Espey.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Indian Health Service.

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Wong, C.A., Jim, M.A., King, J. et al. Impact of hysterectomy and bilateral oophorectomy prevalence on rates of cervical, uterine, and ovarian cancer among American Indian and Alaska Native women, 1999–2004. Cancer Causes Control 22, 1681–1689 (2011). https://doi.org/10.1007/s10552-011-9844-2

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