title: Gallbladder cancer incidence among American Indians and Alaska Natives, US, 1999-2004.
abstract: BACKGROUND
  Gallbladder cancer (GBC) is rare; however, it disproportionately affects the American Indian and Alaska Natives (AI/AN) population. The purpose of the study was to characterize GBC among AI/AN in the US population.
  
  
  METHODS
  Cases of GBC diagnosed between 1999 and 2004 and collected by state-based cancer registries were included. Registry records were linked with Indian Health Service (IHS) administration records to decrease race misclassification of AI/AN. GBC rates and/or percent distributions for AI/AN and non-Hispanic whites (NHW) were calculated by sex, IHS region, age, and stage for all US counties and IHS Contract Health Service Delivery Area (CHSDA) counties, in which approximately 56% of US AI/AN individuals reside.
  
  
  RESULTS
  In CHSDA counties, the GBC incidence rate among AI/AN was 3.3 per 100,000, which was significantly higher than that among NHW (P < .05). Rates varied widely among IHS regions and ranged from 1.5 in the East to 5.5 in Alaska. Rates were higher among AI/AN females than males in all regions, except the Northern Plains. Higher percentages of GBC were diagnosed among AI/AN aged <65 years compared with NHW. GBC was most often diagnosed at the regional stage among AI/AN, whereas GBC was most often diagnosed at regional or distant stages among NHW.
  
  
  CONCLUSIONS
  To the authors' knowledge to date, this is the most comprehensive study of GBC incidence among AI/AN in the US. The accurate characterization of GBC in this population could help inform the development of interventions aimed at reducing morbidity and mortality from this disease.
authors: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA.
authors: Shannon M
authors: SM
authors: Lemrow
authors: David G
authors: DG
authors: Perdue
authors: Sherri L
authors: SL
authors: Stewart
authors: Lisa C
authors: LC
authors: Richardson
authors: Melissa A
authors: MA
authors: Jim
authors: Helen T
authors: HT
authors: French
authors: Judith
authors: J
authors: Swan
authors: Brenda K
authors: BK
authors: Edwards
authors: Charles
authors: C
authors: Wiggins
authors: Lois
authors: L
authors: Dickie
authors: David K
authors: DK
authors: Espey
mesh_terms: D000368:Aged; D000413:Alaska / Q000453:epidemiology; D005260:Female; D005706:Gallbladder Neoplasms / Q000208:ethnology*; D005843:Geography; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D008875:Middle Aged; D011159:Population Surveillance; D044469:Racial Groups / Q000706:statistics & numerical data; D012042:Registries; D014481:United States / Q000453:epidemiology