Objectives. We examined behavioral trends associated with cancer risk and cancer screening use from 1997 through 2006 among American Indians/Alaska Natives (AI/ANs) in the Northern Plains region (North Dakota, South Dakota, Nebraska, and Iowa) of the United States. We also examined disparities between that population and non-Hispanic white (NHW) people in the Northern Plains and AI/ANs in other regions. Results. There was no statistically significant improvement among AI/ANs in the Northern Plains region for behaviors associated with cancer risk or cancer screening use, and there was a significant increase in the obesity rate. The prevalence of binge drinking, obesity, and smoking among AI/ANs in the Northern Plains was significantly higher than among NHW people in the same region and among AI/AN populations in other regions. Although the percentage of cancer screening use was similar for all three groups, the use of sigmoidoscopy/colonoscopy was significantly lower among the Northern Plains AI/ANs than among NHW people.Conclusion. These results indicate a need for increased efforts to close the gaps in cancer health disparities between AI/ANs and the general population. Future efforts should focus not only on individual-level changes, but also on system-level changes to build infrastructure to promote healthy living and to increase access to cancer screening.
IntroductionPopulation-based data are essential for quantifying the problems and measuring the progress made by comprehensive cancer control programs. However, cancer information specific to the American Indian/Alaska Native (AI/AN) population is not readily available. We identified major population-based surveys conducted in the United States that contain questions related to cancer, documented the AI/AN sample size in these surveys, and identified gaps in the types of cancer-related information these surveys collect.MethodsWe conducted an Internet query of US Department of Health and Human Services agency websites and a Medline search to identify population-based surveys conducted in the United States from 1960 through 2010 that contained information about cancer. We used a data extraction form to collect information about the purpose, sample size, data collection methods, and type of information covered in the surveys.ResultsSeventeen survey sources met the inclusion criteria. Information on access to and use of cancer treatment, follow-up care, and barriers to receiving timely and quality care was not consistently collected. Estimates specific to the AI/AN population were often lacking because of inadequate AI/AN sample size. For example, 9 national surveys reviewed reported an AI/AN sample size smaller than 500, and 10 had an AI/AN sample percentage less than 1.5%.ConclusionContinued efforts are needed to increase the overall number of AI/AN participants in these surveys, improve the quality of information on racial/ethnic background, and collect more information on treatment and survivorship.
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