title: Impact of hysterectomy and bilateral oophorectomy prevalence on rates of cervical, uterine, and ovarian cancer among American Indian and Alaska Native women, 1999-2004.
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.
authors: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention, Atlanta, GA, USA.
authors: Charlene A
authors: CA
authors: Wong
authors: Melissa A
authors: MA
authors: Jim
authors: Jessica
authors: J
authors: King
authors: Lillian
authors: L
authors: Tom-Orme
authors: Jeffrey A
authors: JA
authors: Henderson
authors: Mona
authors: M
authors: Saraiya
authors: Lisa C
authors: LC
authors: Richardson
authors: Larry
authors: L
authors: Layne
authors: Anil
authors: A
authors: Suryaprasad
authors: David K
authors: DK
authors: Espey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000413:Alaska / Q000453:epidemiology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data; D004930:Inuit / Q000706:statistics & numerical data; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000453:epidemiology*; D010052:Ovariectomy / Q000706:statistics & numerical data*; D015995:Prevalence; D018426:SEER Program; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology*; D014594:Uterine Neoplasms / Q000453:epidemiology*; D055815:Young Adult