Effectiveness of Interventions to Increase Colorectal Cancer Screening Among American Indians and Alaska Natives

Abstract

What is already known about this topic? Reducing client and structural barriers can result in greater participation in colorectal cancer screening, when stool-based tests are used. What is added by this report? Direct mailing of fecal immunochemical test kits was an effective strategy to increase colorectal cancer screening participation at rural, tribally operated health care facilities. What are the implications for public health practice? Stool-based testing is often the most accessible colorectal cancer screening option at rural, tribally run health care facilities. Direct mailing of fecal immunochemical tests may increase colorectal screening at health care facilities that serve American Indian and Alaska Native populations.

Colorectal cancer community engagement: a qualitative exploration of American Indian voices from North Dakota

“…Similarities were also found between our results and that of other cancers such as breast cancer in other AI communities [ 41 ]. This similarity finding may mean that other AI communities’ or regions’ colorectal cancer prevention efforts may have applicability in tribal communities in North Dakota [ 42 – 44 ]. Appropriate local adaptations will still likely be needed due to important cultural nuances.…”

Cancer disparities among non‐Hispanic urban American Indian and Alaska Native populations in the United States, 1999‐2017

“…19 Other collaborations with tribal organizations in Alaska, Minnesota, Arizona, New Mexico, and various health facilities in the Northern Plains have also been established to improve colorectal cancer screening, implement Cancer April 15, 2022 screening navigator services, and develop patient educational resources to increase awareness of colorectal cancer screening. [20][21][22] The CDC has also funded organizations such as the American Indian Cancer Foundation (AICAF) to support Urban Indian Health Programs nationally through screening, navigation, and evidence-based interventions (EBIs). 23 These EBIs have been centrally focused on 5 specific topics-human papillomavirus, colorectal cancer, hepatitis C, tobacco cessation, and survivorship.…”

“…The CDC's National Breast and Cervical Cancer Early Detection Program provides breast cancer screening for 33% of eligible AI/AN women 19 . Other collaborations with tribal organizations in Alaska, Minnesota, Arizona, New Mexico, and various health facilities in the Northern Plains have also been established to improve colorectal cancer screening, implement screening navigator services, and develop patient educational resources to increase awareness of colorectal cancer screening 20‐22 …”

American Indian/Alaska Native and black colon cancer patients have poorer cause-specific survival based on disease stage and anatomic site of diagnosis

“…Some have reported that Black persons were less likely than White persons to receive surgical treatment and adjuvant chemotherapy [ 39 – 42 ]. Differences in posttreatment surveillance and comorbidities among AIAN and NHB persons may also influence survival disparities [ 6 , 36 ]. That AIAN persons’ cause-specific survival probabilities decrease faster than all other races for localized-stage CCs over five years suggests suboptimal CC treatment relative to that of non-AIAN persons: the average per capita healthcare expenditures for the IHS population were $4078 in 2019, less than half the corresponding expenditures for the general US population [ 43 ].…”