TABLE 2—
Invasive Cervical Cancer Incidence Rates by Age and Indian Health Service Region for American Indian/Alaska Native and White Women: United States, 1999–2009
| CHSDA |
All Counties |
|||||
| AI/AN,a,b Count (Rate) | White,a Count (Rate) | AI/AN:White RR (95% CI) | AI/AN, Count (Rate) | White, Count (Rate) | AI/AN:White RR (95% CI) | |
| Total | 799 (11.0) | 18 950 (7.1) | 1.55* (1.44, 1.66) | 1020 (8.7) | 87 302 (7.5) | 1.54* (1.32, 1.77) |
| Age, y | ||||||
| < 25 | 27 (0.7) | 271 (0.3) | 2.18* (1.41, 3.23) | 30 (0.5) | 1097 (0.3) | 1.69* (1.13, 2.42) |
| 25–44 | 379 (16.5) | 7473 (11.5) | 1.43* (1.28, 1.58) | 485 (13.1) | 34 054 (11.9) | 1.10* (1.01, 1.21) |
| 45–64 | 283 (16.3) | 7339 (11.0) | 1.48* (1.31, 1.67) | 370 (12.7) | 33 560 (11.7) | 1.08 (0.98, 1.20) |
| 65–84 | 96 (17.2) | 3317 (9.2) | 1.86* (1.50, 2.29) | 118 (13.5) | 15 939 (10.2) | 1.32* (1.09, 1.58) |
| ≥ 85 | 14 (22.3) | 550 (8.0) | 2.80* (1.52, 4.74) | 17 (17.0) | 2652 (8.8) | 1.93* (1.12, 3.10) |
| IHS Region | ||||||
| Northern Plains | 149 (13.3) | 2948 (6.8) | 1.97* (1.65, 2.34) | 206 (11.1) | 15 664 (7.2) | 1.54* (1.32, 1.77) |
| Alaska | 67 (13.1) | 165 (6.8) | 1.94* (1.42, 2.62) | 67 (13.1) | 165 (6.8) | 1.94* (1.42, 2.62) |
| Southern Plains | 234 (15.1) | 1574 (9.2) | 1.64* (1.43, 1.89) | 268 (12.6) | 7907 (8.3) | 1.53* (1.34, 1.73) |
| Southwest | 176 (8.3) | 2659 (7.0) | 1.19* (1.01, 1.39) | 190 (8.1) | 4282 (6.5) | 1.25* (1.07, 1.45) |
| Pacific Coast | 133 (9.6) | 5671 (7.0) | 1.36* (1.13, 1.63) | 167 (8.0) | 10 588 (6.9) | 1.15 (0.98, 1.35) |
| East | 40 (8.4) | 5933 (7.1) | 1.18 (0.83, 1.62) | 122 (4.5) | 48 696 (7.8) | 0.58* (0.48, 0.69) |
| Stage | ||||||
| Localized | 194 (4.5) | 4563 (3.4) | 1.34* (1.15, 1.55) | 259 (3.7) | 21 391 (3.5) | 1.04 (0.92, 1.18) |
| Regional | 166 (4.0) | 3347 (2.2) | 1.84* (1.56, 2.16) | 204 (3.0) | 16 041 (2.4) | 1.27* (1.09, 1.46) |
| Distant | 56 (1.4) | 1274 (0.8) | 1.74* (1.30, 2.28) | 71 (1.1) | 5893 (0.8) | 1.29* (1.00, 1.64) |
| Unstaged | 45 (1.1) | 835 (0.5) | 2.15* (1.53, 2.93) | 59 (0.9) | 3529 (0.5) | 1.78* (1.34, 2.33) |
Note. AI/AN = American Indian/Alaska Native; CHSDA = Contract Health Service Delivery Areas; CI = confidence interval; IHS = Indian Health Service; RR = rate ratio. Women of Hispanic origin are excluded from the analyses. AI/AN race is reported by National Program of Cancer Registries and Surveillance, Epidemiology, and End Results registries or through linkage with the IHS patient registration database. Rates are per 100 000 persons and are age-adjusted to the 2000 US standard population (19 age groups; Census P25-1130).29 RRs are calculated in SEER*Stat before rounding of rates and may not equal RRs calculated from rates presented in the table. IHS regions are defined as follows: Northern Plains (IL, IN,b IA,b MA,b MN,b MT,b NE,b ND,b SD,b WI,b WYb); Southern Plains (OK,b KS,b TXb); Southwest (AZ,b CO,b NV,b NM,b UTb); Pacific Coast (CA,b ID,b OR,b WA,b HI); East (AL,b AR, CT,b DE, FL,b GA, KY, LA,b ME,b MD, MA,b MS,b MO, NH, NJ, NY,b NC,b OH, PA,b RI,b SC,b TN, VT, VA, WV, DC, IL, IN,b IA,b MIb). Percent regional coverage of AI/AN persons in CHSDA counties to AI/AN persons in all counties: Northern Plains = 64.8%; Alaska = 100%; Southern Plains = 76.3%; Southwest = 91.3%; Pacific Coast = 71.3%; East = 18.2%; total US = 64.2%.
Source. Data are from population-based cancer registries that participate in the National Program of Cancer Registries or the Surveillance, Epidemiology, and End Results Program, and meet criteria for high quality data. Years of data and registries used: 1999–2009 (43 states): AK, AL, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, TX, UT, VT, WA, WV, WY; 1999–2008: WI; 1999–2001 and 2003–2009: DC; 2001–2009: AR, NC, SD; 2002–2009: VA; 2003–2009: MS, TN.
Among unstaged cases, 4 women were diagnosed after death (death certificate only).
Identifies states with at least 1 county designated as CHSDA.
*P < .05.