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

Linda J. DemmaEnteric Disease Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Arctic Investigations Program, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Anchorage, Alaska; Division of Program Statistics, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Rockville, Maryland; Division of Epidemiology, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Albuquerque, New Mexico

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Robert C. HolmanEnteric Disease Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Arctic Investigations Program, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Anchorage, Alaska; Division of Program Statistics, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Rockville, Maryland; Division of Epidemiology, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Albuquerque, New Mexico

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Jeremy SobelEnteric Disease Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Arctic Investigations Program, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Anchorage, Alaska; Division of Program Statistics, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Rockville, Maryland; Division of Epidemiology, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Albuquerque, New Mexico

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Krista L. YoritaEnteric Disease Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Arctic Investigations Program, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Anchorage, Alaska; Division of Program Statistics, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Rockville, Maryland; Division of Epidemiology, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Albuquerque, New Mexico

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Thomas W. HennessyEnteric Disease Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Arctic Investigations Program, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Anchorage, Alaska; Division of Program Statistics, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Rockville, Maryland; Division of Epidemiology, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Albuquerque, New Mexico

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Edna L. PaisanoEnteric Disease Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Arctic Investigations Program, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Anchorage, Alaska; Division of Program Statistics, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Rockville, Maryland; Division of Epidemiology, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Albuquerque, New Mexico

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James E. CheekEnteric Disease Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Division of Viral and Rickettsial Diseases, National Center for Zoonotic, Vector Borne, and Enteric Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia; Arctic Investigations Program, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Anchorage, Alaska; Division of Program Statistics, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Rockville, Maryland; Division of Epidemiology, Office of Public Health Support, Indian Health Service, U.S. Department of Health and Human Services, Albuquerque, New Mexico

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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.

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