There are over 560 federally recognized tribes and over 100 state recognized tribes, of which each has its own unique culture. Thus, there is great diversity within American Indian and Alaska Native political, social, cultural, and spiritual communities. (1) As was true in earlier years (2), preliminary data from US Census 2000 continues to report American Indians and Alaska Natives as having younger median age in comparison to other racial groups. (3) Since cancer is primarily a disease that affects older people, this younger median age partially explains why cancer appears to be less common among selected Native communities. Likewise, American Indians and Alaska Natives continue to be among the poorest populations in the US (3,4) There are 217 native languages spoken today and most, if not all, indigenous languages do not include a word for "cancer". (5) According to US Census Bureau August 2000 Population Estimates, the states with the highest numbers of American Indians are California (313,642), Oklahoma (262,581), Arizona (261,168), New Mexico (165,444), Washington (104,819), Alaska (101,352), North Carolina (99,277), Texas (97,412), New York (76,755), and Florida (60,358). (3) The states with the highest percentage of American Indians and Alaska Natives include Alaska (16.4%), New Mexico (9.5%), South Dakota (8.2%), Oklahoma (7.8%), Montana (6.5%), Arizona (5.5%), North Dakota (4.8%), Wyoming (2.3%), Washington (1.8%), and Nevada (1.8%). (3) Approximately 60% of the American Indian and Alaska Native population reside in urban areas with the highest number of American Indians in Los Angeles, California while the urban area with the highest number of Alaska Natives is Anchorage, Alaska. (3,4) (See Intercultural Cancer Council American Indian/Alaska Native Cancer Facts)
- US Census Bureau. States ranked by American Indian and Alaska Native
population, July 1, 1999. Population Estimates Program, Population
Division, US Census Bureau, Washington, DC 20233; 2000 August 30.
Available from: URL: http://www.census.gov/population/estimates/state/rank/aiea.txt
- US Department of Commerce. Bureau of the Census. Selected social and
economic characteristics by race and Hispanic origin for the United
States. American Indian population by tribe for the United States,
regions, divisions, and states: 1990. Washington, DC: Government
Printing Office; 1992. CPH-L-99.
- US Department of
Commerce. Bureau of the Census. We the first Americans. Washington, DC:
US Government Printing Office; 1993. Pub. No. 350-631.
- Dixon M, Roubideaux Y, editors. Promises to keep. Washington, DC: American Public Health Association; in press Winter 2001.
Cancer Incidence (the number of people who are diagnosed with cancer
The following information was presented during the 2010 “Roots of Strength” Survivor/Scientist conference by Chuck Wiggins. His topic was “What is Cancer and Why is it Important to Indian People?” He can be reached at:
New Mexico Tumor Registry
MSC 11 6020
1 University of New Mexico
Albuquerque, New Mexico 87131
Native People’s Circle of Hope is nonprofit national organization that focuses on Native Americans diagnosed with cancer.
Where a Native American person lives influences the number of people diagnosed with the disease.
For example, an Alaska Native will get breast cancer at about the same rate as a non-Hispanic White, while Native women living in the southwest will get breast cancer at a far lower rate than non-Hispanic whites.
On the other hand, it is Native men in the Northern Plains area that are getting prostate cancer slightly more so than non-Hispanic white men, while the Alaska Native men are getting prostate cancer at significantly lower rates
Alaska Native and Northern Plains men and women are diagnosed with colorectal cancer more often than in other parts of the country.
Note the remarkably high rates for Alaska Native men and women.Alaskan Natives and Natives living in the Northern Plains, Alaska and Southern Plains have high rates of lung cancer too. (See the section on Cigarette Smoking and Cancer among Native Americans for a discussion on a possible link to the high lung cancer rates.)Finally, stomach cancer is a particular concern for Native Americans living throughout the United States.
Cancer Mortality (the number of people who die from cancer)
Death rates from cancer are not good. The President’s Cancer Panel, Facing Cancer in Indian Country: The Yakama Nation and Pacific Northwest Tribes: President’s Cancer Panel, 2002 Annual Report stated:
Cancer is the second leading cause of death among Native Americans, exceeded only by heart disease. Much of the available national data suggest that cancer incidence among Native Americans is lower than the national average for all races combined, but this assessment in part reflects the younger average age of the Native population (27.8 years versus 35.8 years, U.S. All Races). Most cancers occur at older ages, and Native Americans have fewer individuals in the older age groups compared with the general population. Cancer mortality among Native people, however, appears to be higher than the national averages. A number of studies have observed that during the past three decades, Native American cancer incidence and mortality rates have been increasing, and that American Indian and Alaska Native cancer survival rates are the lowest of any ethnic group. Limited data indicate a five-year cancer survival rate for Native Americans nationally of 36 percent, compared with 47 percent among other Americans. Lower survival and higher mortality are believed to be associated with late-stage diagnosis due to limited access to care, particularly specialty care.
Fatalism about cancer is very strong in Native populations, because their experience has been that nearly everyone who develops cancer dies from it. As a result, interest in screening may be limited, because cancer is viewed as a death sentence and people fear the disease, its treatment, and treatment costs. Having cancer still carries a strong stigma for many Americans Indians and Alaska Natives and can be a major barrier to prompt care and family support. Many believe that stress can cause illness, including cancer. Presenters noted that cancer education and screening interventions that emphasize finding illness are at odds with Native health attitudes that promoting wellness and harmony. Cancer education has been difficult in part because of the lack of communication infrastructure on many reservations. Many do not have telephones, and most communication is by word of mouth. For this reason, outreach by CHRs or similar workers is critical to reach residents in remote areas.”
Death from lung cancer and colorectal cancer has increased among Native American men between 1992 and 2002. Death from stomach cancer and oral cavity cancers increased for Native American men and women during the same time period” See the Journal of the National Cancer Institute, Vol. 97, No. 19, October 5, 2005 pages 1411 -1412.
Cigarette Smoking and Cancer among Native Americans
American Lung Association states in their Smoking and American Indians/Alaska Natives Fact Sheet-April 2006:
- Among racial and ethnic groups, the prevalence of current smoking is highest among American Indians/Alaska Natives (33.4%), intermediate among non-Hispanic whites (22.2%) and non-Hispanic blacks (20.2%) and lowest among Hispanics (15%) and Asians/Pacific Islanders (11.3%)
- Smoking rates and consumption among American Indians and Alaska Natives vary greatly by region and state. Smoking rates are highest among Alaskan Natives (45.1%) and the Northern Plains tribes (44.2%) and lowest among southwest tribes (17.0%). The prevalence of heavy smoking (25+ cigarettes per day) is also highest in the Northern Plains (13.5%)
- American Indian and Alaska Native lands are sovereign nations and are not subject to taxes or state laws prohibiting the sale and promotion of tobacco products to minors. As a result, American Indian and Alaska Native youth have access to cheap tobacco products at a young age. Tobacco is also considered a sacred gift and it is used during religious ceremonies and as traditional medicine.
- Chronic cigarette smoking and spit tobacco use increases their risk of developing tobacco-related health problems. Tobacco use is a risk factor for heart disease, cancer, and stroke—all leading causes of death among American Indians and Alaska Natives.
- Although American Indians have the highest rates of current smoking, they are less likely to be heavy smokers. The percentage of American Indian and Alaska Native smokers who reported that they were light smokers (smoking fewer than 15 cigarettes per day) was 55.3 percent compared to 45.6 percent in whites.
- In 2003, American Indian and Alaska Native women had the highest rate of smoking during pregnancy (18.1%) compared to non-Hispanic white (14.3%) and non-Hispanic black (8.3%) women.
- American Indian and Alaska Natives young adults also have the highest rates of current smoking compared to other racial/ethnic groups. In 2003, 41 percent of American Indian and Alaska Native young adults smoked compared to 26 percent in whites.
- In 2003, only 40.8 percent of American Indian/Alaska Native smokers tried to quit for at least one day compared to 42.4 percent of white smokers.
- As smoking declined among the white non-Hispanic population, tobacco companies targeted American Indian/Alaskan Natives by funding cultural events such as powwows and rodeos to build it image and credibility in the community.
- Morbidity and Mortality Weekly Report. Cigarette Smoking Among Adults-US, 2004. Vol 54, No. 44, Nov. 2005; 1121-1124
- U.S. Department of Health and Human Services. Tobacco Use Among U.S. Racial/Ethnic Minority Groups-African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: A report of the Surgeon General. 1998.
- National Center for Health Statistics. Raw Data from the National Health Interview Survey, U.S., 1997-2003. (analysis by the American Lung Association Research and Program Services Division, Using SPSS and SUDAAN)
- National Center for Health Statistics: National Vital Statistics System Birth Data, 2003. Vol. 54, No. 2, September 2005.
- National Center for Health Statistics. Raw Date from the National Health Interview Survey, U.S., 1997-2003 (Analysis by the American Lung Association Research and Program Services Division, Using SPCC and SUDAAN)
- U.S. Department of Health and Human Services. Tobacco Use Among U.S. Racial/Ethnic Minority Groups-African Americans, American Indians and Alaska Natives, Asian Americans and pacific Islanders, and Hispanics: A report of the Surgeon General. 1998.
Annual Report to the Nation on the Status of Cancer, 1975-2002, Featuring Population-Based Trends in Cancer Treatment. B. Edwards, M. Brown, P.A. Wingo, H. Howe, E. Ward, L. Ries, D Schrag, P. Jamison, A. Jemal, X Wu, C. Friedman, L Harlan, J Warren, R. Anderson, L. Pickle, Journal of the National Cancer Institute, Vol. 97, No 19, October 5, 2005.)
Incidence (People diagnosed with disease)
For the general population the number of people diagnosed with cancer increased then decreased between 1975 and 2004. In 1992 the increase stopped and then began going down.
General Cancer Incidence Trend
For Native American men, the number of cancer cases increased as in the general population from 1975 to 1992 when the numbers began to go down. However, the decrease in cancer diagnoses stopped in 1995 and remained about the same up to 2004.
Native American Men’s Cancer
For Native American women , the number of people diagnosed with cancer increased from 1979 to 1986, increased more slowly from 1986 through 1999 and stabilized from 1999 through 2004.
Native American Women’s Cancer