Cancer Control and Population Sciences Home
Native American Initiatives:
Archive of Native American Projects
- UCLA American Indian, Alaska Native Research Program
- Cancer Control among American Samoans
- Colorectal Cancer Screening Behaviors among Alaska Natives
- Five Tribes Cancer Registry
- Native American Student Research Projects
- Patterns of Care Among Native Americans
UCLA American Indian, Alaska Native Research Program
The American Indian, Alaska Native Research Program
was established at the UCLA Center for Health Policy Research in the Fall of 1998, and it has collaborated on the Center's California Health Interview Survey (CHIS), which was supported in part by the National Cancer Institute in 2001 and 2003. The purpose of the survey is to collect information about the health status and access to health care of the state's diverse population for use by public health researchers, planners, and state and local health care officials. CHIS provides the largest sample of American Indian/Alaska Natives in any US health survey.
Cancer Control among American Samoans
An NCI-supported supplement builds on a collaborative research project addressing a major public health education priority of the National Strategic Plan for the Early Detection and Control of Breast and Cervical Cancers. The specific aims are to:
- Develop, implement, and evaluate an innovative breast and cervical cancer control prevention education program specifically designed for American Samoan women, and
- Identify cognitive, normative, social, and structural factors that impede or facilitate behavior change. The study is being conducted in American Samoa and Los Angeles County, CA.
The educational program will be evaluated in terms of its cultural sensitivity, linguistic appropriateness, and effectiveness in enhancing knowledge, affecting attitudes, and modifying behaviors. The results of the study will provide crucial information for development of more comprehensive interventions.
Colorectal Cancer Screening Behaviors among Alaska Natives
Colorectal cancer incidence among Alaska Natives has been the highest among all racial and ethnic groups in the United States. To complicate the matter, one of the recommended screening practices, fecal occult blood testing, has had an unusually high rate of false positives in Alaska Natives due to high rates of infection with Helicobacter pylori.
To understand the current screening practices implemented within the health care systems serving Alaska Natives, investigators at the Southcentral Foundation in Anchorage have abstracted the medical records of Alaska Natives from an urban site (Anchorage) and Yup'ik Eskimos from a rural site in the Yukon-Kuskokwim Delta region. Among the findings was that, of the 102 cases diagnosed in both groups from 1994 through 1998, only one case had been screened either by flexible sigmoidoscopy or colonoscopy prior to diagnosis.
The objectives of the study were to:
- document the screening recommendations of health care providers;
- identify the screening procedures performed;
- compare rural and urban screening practices; and
- compare screening practices of patients at greater risk due to a history of polyps.
The study made recommendations relative to the future implementation of statewide colorectal cancer screening programs:
- including improving risk communication for both urban and rural groups,
- increasing the number of providers with training in flexible sigmoidoscopy, and
- targeting family members of colorectal cancer patients for increased screening.
The project was performed in collaboration with the Alaska Native Medical Center and the Yukon-Kuskowim Health Corporation and approved by the Alaska Area Indian Health Service Institutional Review Board.
Five Tribes Cancer Registry
Oklahoma, with nearly 40 federally recognized tribal governments, is home to more American Indians than any other state. Of these, the tribes known historically as the Five Civilized Tribes of Oklahoma (Cherokee, Chickasaw, Choctaw, Muscogee (Creek), and Seminole) account for approximately 75% of the estimated tribal population of Oklahoma.
In 2000, the five Chiefs signed an inter-tribal agreement endorsing and supporting the establishment of a cancer registry for people living within the boundaries of the Five Tribes. This pilot project will establish an infrastructure for the inter-tribal tumor registry based on the initial work of the Cherokee Nation. The project also will enhance coordination with reporting requirements established by the Oklahoma health department and co-funded by the CDC National Program of Cancer Registries.
Native American Student Research Projects
The Native American Student Research Projects were built on the 1994 grant, "Native Researchers' Cancer Control Training Program." This series of research projects, which have designated mentors, was developed by program graduates in collaboration with the Network for Cancer Control Research among American Indian and Alaska Native Populations. The projects require development and implementation of a research plan, completion within an established timetable, and a report utilizing analytic skills.
Five projects were funded in 1997, eight in 1998, and five in 1999. Students are required to report their findings to the Network and to the native communities involved in their projects. The original training program has been awarded another five-year grant. The long-term goal of these activities is to provide training and experience for young Native Americans who will proceed to apply for further grants or work in community cancer control programs.
Patterns of Care Among Native Americans
Relatively limited information is available, and even less appears in a published form, that provides a profile of contemporary cancer care among Native American populations. There have been dramatic changes in the health care delivery system for Native American tribes. This is coupled with significant cultural aspects of cancer as a health concern among Native populations.
NCI is funding pilot studies for patterns of care similar to projects currently supported under the special studies mechanism of the SEER Program. Data have been combined from several sources, including SEER and IHS, augmented by abstracted data from medical records in a sample of cancer patients.
