| Summary: | 碩士 === 中國醫藥大學 === 公共衛生學系碩士班 === 104 === Aborigines accounts for 2.3% of the total population (n= 540,023) in Taiwan according to the Aboriginal Commission statistics. Health problem of Taiwan''s Aborigines was easily overlooked in the past. Many countries including United States and Australia recently are concerning and focusing on the health issues of Aborigines more and more. Contrast with the past, we have begun to promote Aboriginal related health issues. There is a progressing trend of the Aboriginal health. However, compared with the general population, it still has a significant gap, for example: the difference of average life expectancy, incidence of disease and disease mortality ranking status. According to the Aboriginal Commission statistical report year 2012, it has showed that Aborigines community average life expectancy has been gradually increased but it still has had big difference comparing with general community. Acute infectious diseases have been excluded from the Aboriginal 10 leading mortality causes although it was before. However, the mortality rate of top ten leading causes among Aborigines community is still higher than the general community currently. Women’s health is better than men in Aboriginal society, but the difference between Aboriginal society women and general population women still is observed.
Cancer is currently an important medical issue worldwide. It is also the top one leading cause of death in women and men. Four-Cancer Screening Project (FCSP) has become an important annual government executing check and review with the project operation. However, the rate of oral cancer, breast cancer and colorectal cancer is still with rising trend year by year. Further improving strategies are needed. Furthermore, studies have shown that health screening behavior among indigenous mountain villages not being as popular as other areas. The latest statistics report also shows that there is an existing gap of four-screening cancer mortality between Aboriginal and non-Aboriginal females. Four-screening cancer morbidity gap between Aboriginal and non-Aboriginal females is an important issue to assess and be prevented. Research shows that Aboriginal population potential has higher probability of tobacco and betel consumption. Liver cancer has been accounted for the second leading cause of cancer mortality among Aboriginal women. Based on the national statistics, Aboriginal women with higher liver cancer mortality than non-Aboriginal women are found. The study is to investigate whether five important cancers, including colorectal cancer, breast cancer, cervical cancer, oral cancer and liver cancer, among women in Indigenous Townships are different with women in non- Indigenous Townships.
The study design was a retrospective cohort study. We used outpatient visits records of Longitudinal Health Insurance Database 2000 (LHID 2000) which included information on patient characteristics, such as age, sex, date of birth, date of visits and diagnoses for outpatient visit (using the International Classification of Disease, Nine Revision, Clinical Modification ICD-9-CM). Male information and missing was excluded from the analyses. We assessed the cancer incidence, prevalence and average disease duration for colorectal cancer, breast cancer, cervical cancer, oral cancer and liver cancer during 2004-2013. Further comparison of female cancer risk in Indigenous Townships (mountain village area and plains area) and non-Indigenous Townships was conducted through multi-variables regression to control potential risk factors.
The result shows that the Indigenous Townships women''s oral cancer incidence and prevalence are both statistically significant higher than non-Indigenous Townships women. Furthermore, the average disease duration is lower among women in Indigenous Townships than women in non-Indigenous Townships. The significant difference was not found for other 3 FCSP cancers (colorectal cancer, breast cancer and cervical cancer). Further assessment of exploring the difference of oral cancer morbidity (incidence and prevalence) between mountain-area and plain-area Indigenous Townships shows no significant difference.
Liver cancer risk of females in Indigenous Townships is higher than non-Indigenous Townships females (OR = 1.80 95% CI = 1.33-2.46) after controlling potential risk factors. Further assessment of liver cancer risk between mountain-area and plain-area of Indigenous Townships points out that there is no significant difference. Further study is suggested.
Keywords: Indigenous Townships; Cervical cancer; Breast Cancer; Colorectal Cancer; Oral Cancer; Liver Cancer
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