Indigenous people disproportionately overlooked in cancer screening and treatment, study finds

A new study in the Journal of the American Medical Association Network adds to the evidence that, if you are a young Native American, the health care system may be the most difficult for you if you are sick with cancer.

To study this, researchers analyzed cancer statistics for more than 290,000 patients between the ages of 15 and 39 from 2004 to 2017. The selected patients had been diagnosed with at least one of the 10 most deadly cancers, including breast, colon, lung, ovarian. and testicular cancer. They then examined differences in diagnosis and survival rates among those patients based on where they fell within five federally defined American ethnic groups (Native Hawaiian or other Pacific Islander, American Indian or Alaska Native, Asian, Black and non-Hispanic white).

They found that there are big differences when it comes to early detection and survival, with white people having the best chances. Rates are particularly high among groups often overlooked in medical research, the Native Hawaiian and Pacific Islander (NHPI) and American Indian or Alaska Native (AIAN) communities.

For example, NHPI patients with melanoma have a 34 percent difference in 10-year survival compared to melanoma patients. Similarly, AIAN lung cancer patients have a 15 percent difference in 10-year survival compared to white patients. The list goes on.

“For example, we found the lowest 10-year survival rates were seen among AIAN patients with cancers of the central nervous system, lung, ovary and testis, and among NHPI patients with cancer such as cervix, colon or rectum, sarcoma and melanoma. Kekoa Taparra, lead author and radiation oncologist at Stanford Health Care, told Salon. “These findings are not just my numbers; they reflect the experiences of my ‘ohana [family] in Hawaii. I have seen many NHPI patients from my ‘ohana, communities in Hawaiʻi, and across the country diagnosed with cancer over the years.”

Taparra’s personal story includes his aunt, who was diagnosed with breast cancer “when I am now old, finally dying from her cancer. These facts confirm the urgent need for targeted research and intervention within these communities.”

The study repeatedly highlights that Indian communities remain underrepresented in medical cancer research, and Taparra explained that this proportion is explained by the number of people actually included in that research. They were as ethnically diverse as the study group.

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“It is important to point out that almost half of the authors who contributed to this study are Indian scholars, which emphasizes the importance of representation in research,” said Taparra. “When scholars come from the communities they study, they bring critical perspectives that ensure the data is well-contextualized, avoiding the traps of academic tourism that tend to erase Indigenous accounts. These diverse perspectives encourage a process inclusive and innovative research, ensures that critical issues such as health disparities facing NHPI and AIAN patients receive attention, support and policy advocacy. what they deserve.”

As the study stated in its conclusion, “Inclusion of indigenous data has revealed ethnic disparities that were previously obscured by data unavailability and aggregation, highlighting the need for consistent inclusion of these categories.” of the ethnic groups defined by the government.”

To remedy this problem, the authors recommend that future health research on such important issues include both NHPI and AIAN populations as research subjects and statistical abstracting scientists.

“This can allow for the accurate identification of health disparities and help the development of targeted interventions,” said Taparra. “Furthermore, these standards were set more than a quarter of a year ago and are still widely ignored. Our research, which emphasizes the importance of such data, shows that NHPI and AIAN patients have gaps some of the most important in the 10-year OS. [overall survival] prices compared to other ethnic groups.”

Taparra also advocated for “knowledgeable health care that understands and addresses the unique challenges faced by the NHPI and AIAN communities.”

This is an ongoing problem and is far from the first study to show racial disparities in cancer survival rates. The Centers for Disease Control and Prevention (CDC) has detailed the various ways that racial discrimination leads to disparities in how disadvantaged groups are diagnosed with different types of cancer. Similarly, a 2022 study in the journal Cancer Epidemiology, Biomarkers & Prevention stated that there is “substantial evidence” that several social factors including racism put people of ethnic minorities at risk. at home to deal with cancer.

“Many have noted the racial/ethnic disparity in cancer outcomes is avoidable and, therefore, unfair,” the authors wrote. “Structural fragmentation, which contributes to many health inequalities, involves a complex combination of macro-level processes, policies, as well as institutional processes and practices that accumulate over time” and results in the unfair advantage of one racial group over another.”