Cancer Surveillance: A Problem for Native Americans and Appalachian Populations

Abstract

Cancer mortality rates appear to be declining for the population of the United States as a whole.1 However, two specific populations— Native Americans and rural white Americans living in Appalachia— appear to have a disproportionate burden of cancer.2 Although some groups of American Indians living in the Southwest have a lower incidence of cancer than the general white population, their cancer survival rate is significantly lower.3 Alaska Natives, according to the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program, have a higher incidence of certain cancers than the total population of the United States as well as the same lower cancer survival rate as the Southwest Indians.4 According to Indian Health Service (IHS) statistics, American Indians living in the Northern Plains have higher cancer mortality than the white population taken as a whole.5 For the eight states participating in the NCI-funded Appalachia Cancer Network (Pennsylvania, New York, Maryland, West Virginia, Ohio, Kentucky, Tennessee, and Virginia), their Appalachian counties, with rural, poor, predominantly white populations, have a higher “all cancer” mortality rate than the overall U.S. rate; five of them have lung and cervical cancer mortality rates higher than the U.S. rates; and six of them have colorectal cancer mortality rates above the U.S. rate.