Cancer in native populations--lessons to be learned.


Cancer incidence rates among Native Americans have, for the most part, been observed to be significantly lower than the general population. There has been, however, some indication that this is changing. The identification of emerging and changing patterns of cancer incidence in Natives is important in the establishment of cancer education, prevention, and screening programs. The present report attempts to put the Native cancer question into focus through a meta-analytic literature review; the presentation of a separate investigation of cancer mortality patterns in a single tribal group covering a 30-year period; and a brief review of cancer survival statistics for Natives. Meta-analytic results indicate that Native males and females experience a significantly lower incidence of cancer than expected. Females were found to experience an elevated risk of cervical cancer. Similar trends were observed in the separate mortality study. Moreover, mortality data indicate that there has been a trend towards increases in mortality from cancer, especially cancers of the lung, colon/rectum, and cervix. Natives experience significantly poorer relative survival rates for most cancer sites. Secular changes in cancer occurrence and mortality coupled with bleak survival statistics argue for the immediate establishment of effective cancer education and screening programs in these populations.