英文摘要
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Objectives: Cervical cancer is one of the most common cancers in women. In Taiwan, about 2000 new cases are diagnosed and about 800 women die each year. The objective of this study was to examine the mortality rates and their trends between aboriginal and non-aboriginal areas from 1986 to 2010. Methods: Data were accessed from the mortality registry kept by the Ministry of Health and Welfare. Demographic data were obtained from the Ministry of the Interior. We used the 5-year demographic distribution in Taiwan in 2000 as the standardized population to calculate the direct standardized mortality rates for cervical cancer. We then compared temporal changes in mortality rates that occurred during 1986-2010. Results: The standardized mortality rates for cervical cancer in Taiwan declined between 1986 and 2010, from 13.18 to 4.45 (per 100,000). Joinpoint regression analysis identified two significant inflection points and three distinct trends between 1986 and 2010. A steady decline from 1986 to 1997 (APC=-1.5, p<.05), and then an acceleration downward after 1997 (APC=-5.3, p<.05), were followed by the largest mortality rate decrease from 2004 to 2010 (APC=-8.7, p<.05). Mortality rates in aboriginal areas fell consistently between 1981 and 2010 (APC=-2.3, p<.05), but no inflection point was identified. In non-aboriginal areas, the joinpoint analysis identified one significant inflection point generating two distinct trends between 1986 and 2010. The first was a steady decline in mortality rates from 1986 to 2002 (APC=-2.3, p<.05), and then a downward acceleration after 2002 (APC=-9.2, p<.05). Conclusions: Standardized mortality rates for cervical cancer declined after the Papanicolaou test was implemented in 1995; however, the mortality rates in aboriginal areas were still higher than those in non-aboriginal areas. The health authorities need to focus on health education and health promotion activities to improve female health in aboriginal areas.
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