Pediatric Cancers among Alaska Native People

Nash, Sarah H.; Zimpelman, Garrett; Schulz, Laura Mendoza; Hirschfeld, Matthew

doi:10.1016/j.jpeds.2020.07.036

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…Cancer has been the leading cause of death in Alaska since 1993 and is the leading cause of death for Alaska Native people [2]. Alaska Native people are disproportionately burdened, both by cancer mortality and incidence, as well as associated risk factors [3][4][5]. In 2017, the cancer mortality rate for Alaska Native people was more than 60% higher than for Non-Native people in Alaska [6].…”

Section: Introductionmentioning

confidence: 99%

“…In 2017, the cancer mortality rate for Alaska Native people was more than 60% higher than for Non-Native people in Alaska [6]. Among Alaska Native people, lung, colorectal, and breast cancer are the most commonly diagnosed cancers, which all have modifiable behavioral risk factors [4,5]. Lung and colorectal cancer are the first and second leading causes of cancer death among Alaska Native people, with incidence rates that are 1.5 and 2.3 times higher, respectively, than for Non-Hispanic Whites in Alaska [7].…”

Section: Introductionmentioning

confidence: 99%

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Learning Together: Sharing Circles in Rural Alaska on Cancer Education Priorities for Youth

2021

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Culturally relevant health promotion with youth is an opportunity to reduce health inequities in cancer. This manuscript describes sharing circles conducted with three communities in the Northwest Arctic region of Alaska. The circles were designed to begin understanding community priorities and lay the foundation to develop culturally relevant cancer education. The project was guided by the principles of Community-Based Participatory Action Research (CBPAR), honored Indigenous ways of knowing, and was grounded in Empowerment Theory. The project team facilitated 13 sharing circles in November 2019 in three communities in the Northwest Arctic. There were a total of 122 participants, including teachers/school staff (31%), community members (30%), high school students (23%), and health professionals (16%). The circles explored youth knowledge, perceptions, questions, concerns, and hopes for cancer information; community members’ desires for youth knowledge about cancer; and how teachers would like content to be formatted for effective inclusion in their classrooms. Common themes from the sharing circles included a desire for information on cancer prevention (all 13 sharing circles) and a need for information on cancer risk factors (12). In most sharing circles, participants shared that cancer information for youth should include stories like those of local people, cancer survivors, and role models (11), visuals (8), and local data and statistics (8). In addition, teachers and school staff in all communities wanted an online resource for teaching about cancer in their classrooms that had short videos/visuals with related lesson plans and activities. “ If I learn, I can reduce the chance of getting cancer in the future. ”

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Learning Together: Sharing Circles in Rural Alaska on Cancer Education Priorities for Youth

2021

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“…29 Physical activity Similar percentages of AIAN and White individuals reported meeting recommended levels of moderate-tovigorous physical activity (52% vs. 58%, respectively) and no leisure-time physical activity (23% vs. 22%, respectively; Table 6). Studies have shown that Alaska Native individuals spend less time in sedentary activities, such as hours spent watching TV, than the general population 86,163 and more time engaging in low-intensity outdoor work, such as wildfood-gathering activities. 164 Infectious agents Helicobacter pylori.…”

Section: Tobaccomentioning

confidence: 99%

Cancer statistics forAmericanIndian andAlaskaNative individuals, 2022: Including increasing disparities in early onset colorectal cancer

Kratzer

Jemal

Miller

et al. 2022

CA A Cancer J Clinicians

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American Indian and Alaska Native (AIAN) individuals are diverse culturally and geographically but share a high prevalence of chronic illness, largely because of obstacles to high-quality health care. The authors comprehensively examined cancer incidence and mortality among non-Hispanic AIAN individuals, compared with non-Hispanic White individuals for context, using population-based data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries. Overall cancer rates among AIAN individuals were 2% higher than among White individuals for incidence (2014 through 2018, confined to Purchased/Referred Care Delivery Area counties to reduce racial misclassification) but 18% higher for mortality (2015 through 2019). However, disparities varied widely by cancer type and geographic region. For example, breast and prostate cancer mortality rates are 8% and 31% higher, respectively, in AIAN individuals than in White individuals despite lower incidence and the availability of early detection tests for these cancers. The burden among AIAN individuals is highest for infection-related cancers (liver, stomach, and cervix), for kidney cancer, and for colorectal cancer among indigenous Alaskans (91.3 vs. 35.5 cases per 100,000 for White Alaskans), who have the highest rates in the world. Steep increases for early onset colorectal cancer, from 18.8 cases per 100,000 Native Alaskans aged 20-49 years during 1998 through 2002 to 34.8 cases per 100,000 during 2014 through 2018, exacerbated this disparity. Death rates for infection-related cancers (liver, stomach, and cervix), as well as kidney cancer, were approximately two-fold higher among AIAN individuals compared with White individuals. These findings highlight the need for more effective strategies to reduce the prevalence of chronic oncogenic infections and improve access to high-quality cancer screening and treatment for AIAN individuals. Mitigating the disparate burden will require expanded financial support of tribal health care as well as increased collaboration and engagement with this marginalized population.

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“…However, cancer mortality rates are not intractable; they have generally declined in Alaska for both the White and Alaska Native populations over the past 20 years [2]. Further, the leading causes of cancer incidence among Alaska Native people (colorectal, lung, and breast) all have modifiable risk factors, which presents an opportunity for health promotion efforts to reduce cancer risk [1,4]. Alaska Native people suffer disproportionately from risk factors that increase cancer risk: in 2020, 36.3% of Alaska Native/ American Indian adults in Alaska reported being current smokers (compared with 14.7% of non-Hispanic White adults in Alaska) [5].…”

Section: Introductionmentioning

confidence: 99%

Cancer Education for High School Students in the Northwest Arctic Increases Knowledge and Inspires Intent to Share Information and Reduce Cancer Risk

Cueva

Schmidt

2023

J Canc Educ

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Culturally appropriate cancer education is an opportunity to reduce health inequities in cancer. This manuscript describes the outcomes of piloting cancer education for youth in the Northwest Arctic region of Alaska. The project began due to community concerns, was focused through sharing circles conducted in the region, and was guided by a community advisory board. The project was based on the principles of Community Based Participatory Action Research (CBPAR), honored Indigenous Ways of Knowing, and was grounded in Empowerment Theory. In response to community requests, eleven cancer education lessons were developed for young people in the Northwest Arctic. Several lessons were piloted in spring 2022. Each participant was invited to complete a pre-lesson and a post-lesson survey. A total of 113 surveys were completed from five different lessons: 66 pre-lesson surveys and 47 post-lesson surveys. Respondents’ mean cancer knowledge scores were significantly higher after the Cancer Basics lesson. On 98% of post-lesson surveys, respondents said they planned to share cancer education messages such as staying tobacco-free and increasing physical activity with others, including their family, friends, and community members. On 93% of the post-lesson surveys, respondents indicated they planned to make changes to reduce their own personal cancer risk, including by staying tobacco-free, eating healthier, and increasing physical activity. “Cancer is serious, and something we should start talking about”.

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Pediatric Cancers among Alaska Native People

Cited by 5 publications

References 27 publications

Learning Together: Sharing Circles in Rural Alaska on Cancer Education Priorities for Youth

Learning Together: Sharing Circles in Rural Alaska on Cancer Education Priorities for Youth

Cancer statistics forAmericanIndian andAlaskaNative individuals, 2022: Including increasing disparities in early onset colorectal cancer

Cancer Education for High School Students in the Northwest Arctic Increases Knowledge and Inspires Intent to Share Information and Reduce Cancer Risk

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