DULUTH - Once she took the lead Saturday, Buzunesh Deba didn't bother sneaking a look at the women pursuing her in Grandma's Marathon. She didn't need to.

Deba ditched fellow Ethiopian Yeshimebet Bifa at mile 19 and went on to win the women's crown with a dominant performance in Duluth. Her time of 2 hours, 31 minutes, 35 seconds set a personal best and put her across the finish line nearly four minutes ahead of Bifa. Deba, 22, has won five consecutive races in a streak that began with the California International Marathon last December.

Everlyne Lagat, a native Kenyan who lives and trains in Albuquerque, N.M., finished third in 2:37:24. The day's most courageous performance belonged to three-time defending champion Mary Akor, who was taken to the medical tent for intravenous fluids and pain medication after coming in fourth with a time of 2:38:01. Akor, 33, delayed surgery to remove uterine fibroids so she could compete at Grandma's and ran despite intense abdominal pain.

"I don't know how far behind the others were," said Deba, one of a group of Ethiopian runners living and training in New York City. "It's hard to lead by yourself. But I had good training. I feel very happy to win."

Deba and Bifa held the lead together at the start of the race and ran that way for most of it. Deba stretched her lead over the final miles, and even when she vomited just before making the turn on Harbor Drive, she knew her margin was wide enough to win handily. Her time was the sixth-fastest by a woman in Grandma's 34-year history.

Akor put off her surgery until Friday because she wanted to run again in Duluth. She has finished among the top four at Grandma's every year since 2005, and her desire to finish the race kept her from dropping out even as her pain grew more severe.

"People kept asking me if I was fine, and I said yes, because I had to stay positive," Akor said. "After three miles, my body wasn't moving at all. I just didn't want to drop out.

"I'm happy I finished, because I was in so much pain. It takes a strong mind to keep going."

Deba won the National Marathon to Fight Breast Cancer in Florida earlier this year, as well as the Naples (Florida) Half Marathon and the Broad Street 10-Miler in Philadelphia. Last year, she finished seventh in the New York City Marathon before beginning her current winning streak.

Her husband, Worku Beyi, came with her to Duluth and finished fourth in Saturday's Garry Bjorklund Half-Marathon.