Growing Cancer Threat Among Native Americans Receiving Scant Attention

BUFFALO, N.Y. -- Cancer is the second leading cause of death among American-Indian and Native-Alaskan women and the third leading cause among American-Indian men, according to available statistics.

While cancer deaths between 1973 and 1990 increased 4 percent in the general population, they increased 10 percent among American Indians, who have the poorest cancer survival rates of any racial group in the United States.

Yet, providers of health care to these populations give cancer a low priority and commit few funds to its prevention, the first studies assessing cancer control programs for Native Americans, conducted by University at Buffalo researchers, have shown.

"At the turn of the century, cancer was so rare among American Indians that people thought they were immune," said Arthur Michalek, Ph.D., UB associate professor of social and preventive medicine and lead author on the studies.

"As late as 1950, cancer still was not an important health issue. But it is a growing menace now, largely because of an increase in life expectancy. In 1950, life expectancy for American Indians was 30 years less than for whites. They didn¹t live l ong enough to be at risk."

The findings come from surveys of state health departments and directors of Native-American health centers in cities and on reservations across the U.S. The studies were conducted by researchers from UB and Roswell Park Cancer Institute, with the aid of Native-American cancer-control programs in Denver, Colo., and Rockville, Md.

Michalek, who is director of education at Roswell Park, said the results predict serious future consequences for these populations. "Many tribes and agencies that work with tribes don¹t have an appreciation for the growing magnitude of this problem. Through these studies we hope to raise the level of awareness of the cancer problem in Indian country, and to try to bring their perceptions into balance with the reality."

A study on tribal-based cancer control activities appeared in Cancer, the Journal of the American Cancer Society, while an urban-based study was published in the Journal of Cancer Education.

€ Tribal health directors ranked cancer fifth in importance out of seven health problems afflicting Native Americans, after alcoholism, diabetes, injuries, and cardiovascular disease.

€ Urban-based directors also ranked cancer fifth, but included AIDS in their top five health concerns.

€ Cancer ranked sixth in funding allotted to combating serious health conditions by tribal health directors.

€ Only 33 percent of urban health directors and 53 percent of tribal health directors were aware that cancer deaths are increasing among Native Americans.

Michalek noted that cancer is still not the No. 1 killer of Native Americans -- accidents and injuries hold that position -- but it is a growing health concern and steps need to be taken, one of which is more research, to protect current and future ge nerations.

"These studies say to researchers ŒIf you want to do something that will have a public health impact, this is it," he said. Such studies must be sensitive to cultural mores, he noted, and will require researchers to stay involved long enough to help native populations implement and evaluate new programs.

Additional researchers on the studies were Martin C. Mahoney, M.D., Ph.D., from the UB Department of Family Medicine, and Martha Tenney and Linda Burhansstipanov from the Native American Cancer Research Program in Denver, Colo.

Nat Cobb, M.D., of the Cancer Prevention and Control Program, Indian Health Service, Rockville Md., also participated in the urban-based study, and Deanna Tome, from Roswell Park, contributed to the tribal-based study.

The research was supported by a National Cancer Institute Cancer Education Grant.