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Epidemiology of Hospitalizations Associated with Ulcers, Gastric Cancers, and Helicobacter pylori Infection among American Indian and Alaska Native Persons

To describe the epidemiology of ulcers, gastric cancer, and Helicobacter pylori infection among American Indian (AI) and Alaska Native (AN) persons, we analyzed hospitalization discharge records with physician discharge diagnoses coded as ulcer, gastric cancer, and mucosa-associated lymphoid tissue (MALT) lymphoma during 1980 to 2005, and H. pylori during 1996 to 2005 from the Indian Health Service Inpatient Dataset. The average annual age-adjusted rate of hospitalizations that included an ulcer-associated condition was 232.4 per 100,000 AI/AN persons. The age-adjusted rate for gastric cancer was 14.2 per 100,000 persons. MALT lymphoma was listed as a discharge diagnosis at an age-adjusted rate of 6.1 per 100,000, and the age-adjusted rate of H. pylori discharge diagnoses was 28.2 per 100,000. The AI/AN persons living in the Alaska region and those 65 years old had the highest rates of hospitalizations that listed ulcer-associated conditions, gastric cancers, MALT lymphoma, and H. pylori as a discharge diagnosis.

Received June 15, 2007. Accepted for publication February 19, 2008.

Acknowledgments: The authors thank Patricia M. Griffin (CDC) for helpful manuscript comments, John Redd, Barbara Strzelczyk (IHS), and Dana Haberling (CDC) for technical assistance, and the staff of all the participating hospitals.

Funding for this report was provided by the United States Department of Health and Human Services, Centers for Disease Control and Prevention.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent those of the funding agencies.

^* Address correspondence to Linda J. Demma, Division of Bacterial and Mycotic Diseases, MS D-63, Atlanta, GA 30333. E-mail: ldemma{at}emory.edu

Authors’ addresses: Linda J. Demma, Division of Bacterial and Mycotic Diseases, MS D-63, Atlanta, GA 30333, E-mail: ldemma{at}emory.edu. Robert C. Holman, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS A-39, Atlanta, GA 30333. Jeremy Sobel, Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS A-38, Atlanta, GA 30333, E-mail: jsobel{at}cdc.gov. Krista L. Yorita, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS A-30, Atlanta, GA 30333. Thomas W. Hennessy, Arctic Investigations Program, Centers for Disease Control and Prevention, 4055 Tudor Centre Rd., Anchorage, Alaska 99508, E-mail: tbh0{at}cdc.gov. Edna L. Paisano, Division of Program Statistics, Office of Public Health Support, Indian Health Service, Rockville, MD 20852, E-mail: Edna.Paisano{at}ihs.gov. James E. Cheek, Division of Epidemiology, Office of Public Health Support, Indian Health Service, Albuquerque, NM 87110, E-mail: James.Cheek{at}ihs.gov.