1. Cancer 101: A Cancer Education and Training Program for American Indians & Alaska Natives Cancer 101: A Cancer Education and Training Program for American Indians & Alaska Natives Version 2 – Updated October 2011 Date Location Presented by: Presenter 1 Presenter 2

2. Cancer Among American Indians & Alaska Natives Cancer 101 – Version 2 Learning Module 1

3. Learning Objectives At the completion of Module 1, you will be able to:  Give two reasons why cancer is a growing health concern in AI/AN communities.  Discuss two facts about how data contributes to understanding about the cancer health concern for AI/AN.

4. Learning Objectives (cont’d)  Discuss two facts that contribute to poor survival for AI/AN diagnosed with cancer.  Describe two factors that are likely to improve cancer survival rates for AI/AN.

5. Actual Causes of Death Source: 1. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238-1246. 2. Miniño AM, Arias E, Kochanek KD, Murphy SL, Smith BL. Deaths: final data for 2000. National Vital Statistics Reports 2002; 50(15):1–120.

6. Cancer Background Cancer is a growing health concern among AI/AN due to:  Increased life expectancy  Lifestyle changes

7. Data Tell Us  The incidence of cancer among AI is lower than all other ethnic groups, including whites, in the U.S.  Cancer rates, previously reported as being lower in AI/AN, are on the rise Source: American Cancer Society Facts & Figures 2009

8. Data Tell Us  Cancer is the second leading cause of death for American Indians.  Cancer is the leading cause of death for Alaska Natives.

9. Data Patterns  Patterns for certain types of cancer vary among AI/AN when compared to whites and other ethnic groups in the U.S.  For example, AI/AN have significantly higher rates of stomach, gallbladder, kidney and liver cancers than the U.S. rate

10. Regional Differences  Cancer data for AI/AN from one region of the country cannot be used to generalize Native people living in another part of the country. All US 55.1 All IHS 40.0 Source: Cancer Mortality among AI & AN: Regional Differences, 1999-2003

11. Limitations of the Data  Racial misclassification  Undercounting  Coding errors  Not enough numbers to form a conclusion  Cannot be generalized to Peoples of other areas

12. Cancer Survival among AI/AN  AI/AN have the lowest five-year relative survival rate of all U.S. populations. Potential contributing factors:  Culture and values Poor compliance with recommended treatment Late detection of cancer  Lower socioeconomic status Lack of timely access to state-of-the-art diagnostic treatment methods  Genetic risk factors  Presence of other disease conditions Obesity Diabetes

13. Barriers to Care  Lack of materials and programs that are culturally relevant  Lack of AI/AN health providers  Lack of education and training opportunities  English as a second language  Poverty  Transportation  Cultural beliefs surrounding cancer

14. Improving Cancer Survival Survival can be improved by:  Increasing participation in screening and early detection services  Reducing barriers to care  Reducing risk factors for cancer  Promoting healthy lifestyles

15. In Summary… You now have an understanding of:  How data affects our understanding of cancer as a health concern for AI/AN.  Factors that contribute to later- stage cancer diagnosis among AI/AN.  Ways to improve cancer survival for AI/AN.