Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #121541

Melissa K. Thomas, MSPH, MS, PhD Ca, Community Outreach, OhioHealth, 3726A Olentangy River Road, Columbus, OH 43214, (614)566-5206, thomam3@ohiohealth.com, William Hiermer, Project Hoffnung, PO Box 28103, Columbus, OH 43228, Robert W. Indian, MS, Chronic Disease and Behavioral Epidemiology, Ohio Department of Health, 246 N. High Street, Columbus, OH 43216-0118, and Brenda Sickle-Santanello, MD, FACS, Surgical Oncology Associates of Columbus, 285 E. State St., Suite #300, Columbus, OH 43215.

Background: Ohio contains the world's largest Amish settlement, with 30,000+ in one community. Additionally, the world's fourth largest settlement and several other Amish communities are scattered throughout Ohio in mostly rural, underserved regions. Limited information exists on the burden of cancer among Amish communities due to difficulties in establishing a population denominator.

Methods: Amish directories were obtained from the two largest settlements in Ohio, and demographic data were collected from all women 18 and older in the directories. Breast cancer incidence and mortality rates were queried from the state tumor registry database from 1996-2002 for 13 counties comprising the world's largest and fourth largest Amish settlements. Both datasets were combined, and a methodology was developed to case match a total 19,802 records in order to identify Amish affiliation and breast cancer incidence cases. The same methodology was applied to mortality data.

Results: The calculated age-adjusted incidence rate (2000 U.S. standard population) is 59.4 per 100,000. The average annual rates for Ohio white females and SEER data are 131.6 per 100,000 and 143.2 per 100,000, respectively. Preliminary analyses of breast cancer mortality data indicate a disproportionately higher death rate when compared to Ohio and national rates.

Discussion: While breast cancer incidence among Ohio's Amish women is significantly lower than state and national averages, the death rate is disproportionately higher, indicating possible late stage diagnosis and access to care. Findings from this epidemiological study elucidate the burden of cancer on this seldom-studied culture residing in over half the states in the US.

Learning Objectives:

• Identify three cultural characteristics of the Amish population; Develop a research methodology to identify Amish cases of breast cancer in Amish communities; Discuss the factors that my to contribute to lower breast cancer incidence and higher mortalty rates among Ohio's Amish women when compared to state and national data.

Keywords: Breast Cancer, Epidemiology

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.