Although overall colorectal cancer rates are lower Native Americans than in whites, there are significant regional differences that show a marked increase in colorectal cancer in Alaskan Natives and Native Americans who live in the Northwest Plains.
Alaskan Natives and Alaskan Indians were twice as likely to have colorectal cancer as non-Hispanic whites, and five times as likely as Native Americans living in the Southwest. Native Americans in the Northern Plains were diagnosed with colon or rectal cancer about 40 percent more often than whites.
Alaska natives also were diagnosed with advanced colorectal cancer almost twice as often as white Americans.
On the other hand Native Americans in the Southwest had a significantly lower rate of colorectal cancer than non-Hispanic whites, with less than half the risk. Native Americans in the East and the Pacific Coast also had lower rates. Overall, rates for colorectal cancer among Native Americans and Alaskan Natives and Indians was 9 percent lower than for non-Hispanic whites.
Diet, poverty, smoking, and genetic factors are probably key to the high rates. In addition, lack of funding for screening and prevention education contribute to the problem.
University of Minnesota gastroenterologist David Perdue, MD, MSPH, wrote,
Colorectal cancer incidence rates in American Indian/Alaskan Native populations varied dramatically between regions. Efforts are needed to make colorectal cancer screening a priority, overcome barriers to endoscopic screening, and to engage AI/AN communities in culturally appropriate ways to participate in prevention and early detection programs.
Listen to Minnesota Public Radio interviews with Dr. Perdue, Judith Kauer of the Mayo Clinic, and Kathleen Annette from the Indian Health Service or read the MPR transcript.
SOURCE: Perdue et al., Cancer, Volume 113, Issue S5, September 1, 2008.


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