Skip to main content
Public Health Reports logoLink to Public Health Reports
. 2005 May-Jun;120(3):283–287. doi: 10.1177/003335490512000311

Invasive cervical cancer among American Indian women in the Northern Plains, 1994-1998: incidence, mortality, and missed opportunities.

Richard F Leman 1, David Espey 1, Nathaniel Cobb 1
PMCID: PMC1497716  PMID: 16134569

Abstract

OBJECTIVES: Cervical cancer mortality rates among the American Indian and Alaska Native (AI/AN) population in North and South Dakota were five times the national average (15.6 per 100,000 vs. 3.1 per 100,000, age adjusted) when last evaluated (from 1989 through 1993). Our goals were to update the AI/AN population cervical cancer mortality rates and to present incidence rates for AI/AN women in the region. METHODS: We reviewed charts for women diagnosed with invasive cervical cancer at Indian Health Service (IHS) facilities in North and South Dakota from 1994 through 1998 and collected information about cervical cancer screening and treatment history. Incidence and mortality rates were standardized to the 1970 U.S. population. RESULTS: Twenty-one cases of invasive cervical cancer and eight deaths were identified. Annualized incidence and mortality rates were 11.5 per 100,000 and 4.5 per 100,000. These compare with national all-race/ethnicity rates of 8.5 per 100,000 and 2.7 per 100,000 for incidence and mortality. Fifteen (71%) of 21 cases were diagnosed due to symptoms. CONCLUSIONS: While cervical cancer mortality rates have declined, incidence and mortality rates among AI/AN women remain higher than in the general U.S. population. Increased use of pap tests and careful follow-up of abnormal results should be aggressively promoted among AI/AN women in North and South Dakota.

Full Text

The Full Text of this article is available as a PDF (68.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Attwood M. E., Woodman C. B., Luesley D., Jordan J. A. Previous cytology in patients with invasive carcinoma of the cervix. Acta Cytol. 1985 Mar-Apr;29(2):108–110. [PubMed] [Google Scholar]
  2. Baquet C. R. Native Americans' cancer rates in comparison with other peoples of color. Cancer. 1996 Oct 1;78(7 Suppl):1538–1544. [PubMed] [Google Scholar]
  3. Becker T. M., Wheeler C. M., Key C. R., Samet J. M. Cervical cancer incidence and mortality in New Mexico's Hispanics, American Indians, and non-Hispanic whites. West J Med. 1992 Apr;156(4):376–379. [PMC free article] [PubMed] [Google Scholar]
  4. Benard V. B., Lee N. C., Piper M., Richardson L. Race-specific results of Papanicolaou testing and the rate of cervical neoplasia in the National Breast and Cervical Cancer Early Detection Program, 1991-1998 (United States). Cancer Causes Control. 2001 Jan;12(1):61–68. doi: 10.1023/a:1008959019019. [DOI] [PubMed] [Google Scholar]
  5. Bleed D. M., Risser D. R., Sperry S., Hellhake D., Helgerson S. D. Cancer incidence and survival among American Indians registered for Indian health service care in Montana, 1982-1987. J Natl Cancer Inst. 1992 Oct 7;84(19):1500–1505. doi: 10.1093/jnci/84.19.1500. [DOI] [PubMed] [Google Scholar]
  6. Cannistra S. A., Niloff J. M. Cancer of the uterine cervix. N Engl J Med. 1996 Apr 18;334(16):1030–1038. doi: 10.1056/NEJM199604183341606. [DOI] [PubMed] [Google Scholar]
  7. Cobb N., Paisano R. E. Patterns of cancer mortality among Native Americans. Cancer. 1998 Dec 1;83(11):2377–2383. doi: 10.1002/(sici)1097-0142(19981201)83:11<2377::aid-cncr18>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  8. Davidson M., Bulkow L. R., Lanier A. P., Smith R. A., Hawkins I., Jensen H., Kiviat N. B. Incidence of invasive cervical cancer preceded by negative screening in high-risk Alaska Native women. Int J Epidemiol. 1994 Apr;23(2):238–245. doi: 10.1093/ije/23.2.238. [DOI] [PubMed] [Google Scholar]
  9. Fink D. J. Change in American Cancer Society Checkup Guidelines for detection of cervical cancer. CA Cancer J Clin. 1988 Mar-Apr;38(2):127–128. doi: 10.3322/canjclin.38.2.127. [DOI] [PubMed] [Google Scholar]
  10. Frost F., Taylor V., Fries E. Racial misclassification of Native Americans in a surveillance, epidemiology, and end results cancer registry. J Natl Cancer Inst. 1992 Jun 17;84(12):957–962. doi: 10.1093/jnci/84.12.957. [DOI] [PubMed] [Google Scholar]
  11. Gallup D. C., Nolan T. E., Hanly M. G., Otken L. B., Gallup D. G., Maier R. C. Characteristics of patients with rapidly growing cervical cancer. South Med J. 1997 Jun;90(6):611–615. doi: 10.1097/00007611-199706000-00006. [DOI] [PubMed] [Google Scholar]
  12. Giroux J., Welty T. K., Oliver F. K., Kaur J. S., Leonardson G., Cobb N. Low national breast and cervical cancer-screening rates in American Indian and Alaska Native women with diabetes. J Am Board Fam Pract. 2000 Jul-Aug;13(4):239–245. doi: 10.3122/15572625-13-4-239. [DOI] [PubMed] [Google Scholar]
  13. Kristensen G. B., Skyggebjerg K. D., Hølund B., Holm K., Hansen M. K. Analysis of cervical smears obtained within three years of the diagnosis of invasive cervical cancer. Acta Cytol. 1991 Jan-Feb;35(1):47–50. [PubMed] [Google Scholar]
  14. La Vecchia C., Franceschi S., Decarli A., Fasoli M., Gentile A., Tognoni G. "Pap" smear and the risk of cervical neoplasia: quantitative estimates from a case-control study. Lancet. 1984 Oct 6;2(8406):779–782. doi: 10.1016/s0140-6736(84)90705-0. [DOI] [PubMed] [Google Scholar]
  15. Lanier A. P., Bulkow L. R., Ireland B. Cancer in Alaskan Indians, Eskimos, and Aleuts, 1969-83: implications for etiology and control. Public Health Rep. 1989 Nov-Dec;104(6):658–664. [PMC free article] [PubMed] [Google Scholar]
  16. Macgregor J. E., Moss S. M., Parkin D. M., Day N. E. A case-control study of cervical cancer screening in north east Scotland. Br Med J (Clin Res Ed) 1985 May 25;290(6481):1543–1546. doi: 10.1136/bmj.290.6481.1543. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Mahmoodian S. Cervical and breast cancer screening rates in Sioux Indian women. South Med J. 1997 Mar;90(3):316–320. doi: 10.1097/00007611-199703000-00010. [DOI] [PubMed] [Google Scholar]
  18. Marrett Loraine D., Chaudhry Munaza. Cancer incidence and mortality in Ontario First Nations, 1968-1991 (Canada). Cancer Causes Control. 2003 Apr;14(3):259–268. doi: 10.1023/a:1023632518568. [DOI] [PubMed] [Google Scholar]
  19. 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. Cancer incidence among American Indians and Alaska Natives, 1980 through 1987. Am J Public Health. 1993 Nov;83(11):1589–1598. doi: 10.2105/ajph.83.11.1589. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Partin M. R., Rith-Najarian S. J., Slater J. S., Korn J. E., Cobb N., Soler J. T. Improving cancer incidence estimates for American Indians in Minnesota. Am J Public Health. 1999 Nov;89(11):1673–1677. doi: 10.2105/ajph.89.11.1673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Schwartz P. E., Hadjimichael O., Lowell D. M., Merino M. J., Janerich D. Rapidly progressive cervical cancer: the Connecticut experience. Am J Obstet Gynecol. 1996 Oct;175(4 Pt 2):1105–1109. doi: 10.1016/s0002-9378(96)70012-1. [DOI] [PubMed] [Google Scholar]
  22. Sherman M. E., Kelly D. High-grade squamous intraepithelial lesions and invasive carcinoma following the report of three negative Papanicolaou smears: screening failures or rapid progression? Mod Pathol. 1992 May;5(3):337–342. [PubMed] [Google Scholar]

Articles from Public Health Reports are provided here courtesy of SAGE Publications

RESOURCES