Pages 340-341 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):340-341
Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
The American Indian Cancer Foundation, Minneapolis, MN, USA
Division of Cancer Prevention and Control, Centers for Disease Control, Albuquerque, NM, USA
Source
Pages 340-341 in N. Murphy and A. Parkinson, eds. Circumpolar Health 2012: Circumpolar Health Comes Full Circle. Proceedings of the 15th International Congress on Circumpolar Health, Fairbanks, Alaska, USA, August 5-10, 2012. International Journal of Circumpolar Health 2013;72 (Suppl 1):340-341
Background: Cancer is the leading cause of death among Alaska Native (AN) people, and colorectal cancer (CRC) is the leading cause of new cases of cancer. AN people are disproportionately affected by colorectal cancer, experiencing almost twice the incidence and mortality as US Whites. The AN population also have the highest CRC incidence of all Native American groups, with a CRC incidence that is nearly 5 times higher than that of American Indians living in the US Indian Health Services
Southwest Region. Screening can detect advanced
neoplasia (polyps and cancer), and in the case of
endoscopy, can even prevent cancer by removing precancerous polyps. Although screening is an effective way to reduce CRC mortality, AN screening prevalence varies significantly between regions of the state, from 33 to 72%, with a median of 56% (Government Performance and Results Act (GPRA) data, 2011). Faecal occult blood tests (FOBT) are not currently recommended for use in the AN population due to a high prevalence of Helicobacter pylori-associated haemorrhagic gastritis which results in high false-positive rates, making lower
endoscopy (flexible sigmoidoscopy and colonoscopy) the preferred screening method. Approximately half of the 125,000 AN people in the state live in rural and remote communities that are off the road system and are accessible only by small aircraft, snow machines or boats. CRC screening in Alaska is challenging due to the unique geography and climate which often necessitates long distance, high cost air travel to access endoscopy services.
Goals and objectives: Over the past decade, the Alaska Native Tribal Health Consortium (ANTHC) has worked to improve CRC screening prevalence through the provision of direct screening services, policy and systems changes, provider education and community outreach.