Monograph Highlights Research in Native American Populations

National Cancer Institute
Thursday, 26 August 1999

The National Cancer Institute (NCI) has released a new monograph that summarizes NCI's first concerted nationwide effort to address the cancer prevention and control needs of the Native American population. The report, called Native Outreach: A Report to American Indian, Alaska Native, and Native Hawaiian Communities, highlights the results of seven research studies conducted in Native American communities.

Data on cancer rates among Native Americans vary greatly within smaller groups of Native American communities. According to data collected between 1988 and 1992, breast cancer was the most common form of cancer among American Indian (New Mexico), Alaska Native and Hawaiian women. American Indian women had higher incidence rates for cancers of the cervix, ovary, and gallbladder than the U.S. white female population, while cervical cancer incidence rates among Alaska Native women were twice as high as the U.S. white population. Lung cancer was the leading cause of mortality among Alaska Natives and Hawaiian women, while among American Indian (New Mexico) women, gallbladder cancer deaths were most common. Lung cancer incidence and mortality ranked highest among Alaska Native and Hawaiian men, while among American Indian men, prostate cancer was the most diagnosed cancer and the leading cause of cancer mortality.

"These unique projects were implemented with the cooperation of Native American researchers, staff, and community leaders," said Claudia Sanchez Glover, M.H.S., co-editor of the monograph and a health statistician in the Office of Special Populations Research at NCI. "The use of focus groups helped several studies increase their cultural sensitivity to the Native American community. This made them successful, and taught us that culturally sensitive interventions make a difference in cancer prevention."

The monograph documents findings from seven of eight Native American studies funded by the NCI between 1989 and 1996. There were two kinds of studies: identifying ways to prevent cancer deaths in Native American populations and finding ways to prevent cancer in these populations.

The studies that identified ways to decrease cancer deaths examined the effectiveness of intervention strategies to increase breast and cervical cancer screening among Native American populations. These studies include the Prevention of Cervical Cancer in Alaska Native Women, North Carolina Native American Cervical Cancer Prevention Project, and the Wai`anae Coast Cancer Research Project.

The cancer prevention studies developed innovative prevention and cessation and/or dietary intervention strategies that focused on identifying and modifying behaviors and attitudes about tobacco use (cigarettes and smokeless products) and dietary habits. These studies were the Tobacco Policy Intervention in Northwest Indian Tribes, Smoking Cessation for American Indians, Southwestern Cancer Prevention Project for American Indians, and Reducing Cancer Risks Among Native American Adolescents.

Major findings of the studies include:

- The incidence of cervical cancer is of significant concern in the Native American community;

- American Indians and Alaska Natives have extremely high cigarette smoking prevalence rates. Targeted interventions require culturally appropriate and community-based programs to address this problem;

- Tobacco abuse among American Indian teens is increasing and requires immediate attention;

- Cancer incidence and mortality data are needed for a larger cross section of the American Indian population to more accurately evaluate the cancer burden in this population; and

- Significant involvement of Native American researchers, staff, advisers, and community leaders enhanced the success of the research studies as Native Americans were involved in all phases of the studies.

The monograph is targeted to community leaders, health professionals, and lay health workers to provide models for programs that can be implemented at a community level. Single copies of the report (National Institutes of Health (NIH) Publication 98-4341) and an executive summary (NIH Publication 99-4341S) are available from NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

For more information, or to contact National Cancer Institute, see their website at: www.cancer.gov