Screening & Early Detection

The primary goal of cancer screening is to detect cancer at an early stage. Medical treatments are often more successful when the diagnosis is received earlier in the development of the cancer. Effective cancer screening tests find cancer early, before there are symptoms, and generally screen for cancers that are easier to treat when detected early, and reduce the likelihood of death due to the cancer.

Some of the cancers that can be detected early by screening include breast, cervical, and colorectal cancers. However, access to screening is often limited by healthcare services available locally, healthcare coverage, transportation, time constraints, and cultural barriers.

In areas across the United States, American Indian/Alaska Natives are often found to have low rates of screening compared to the general population.

American Indian/Alaska Native women have the lowest rate of mammography of all ethnic groups. One study found that only 36.6% of AI/AN women over the age of 40 had received a mammography within the past year¹. These rates vary by region and it is important to look into the rates within your specific service community.

For example, research has shown that Alaskan Natives have better screening rates than American Indians from the Southwest US². This difference in screening rate is especially stark regarding colorectal cancer where 83.4% of respondents from the Southwest reported never having a colonoscopy compared to only 48.7% of Alaskan Natives. Forty-one percent of Alaskan Natives reported having had a colonoscopy within the past five years compared to only 11.7% of Southwest American Indians.

If cancer was detected during an initial screening, follow-up screenings become an important part of cancer care. Cancer patients need to understand the importance of participating in these follow-ups in order to monitor the cancer, even if it is in remission or if the patient has been declared “cancer-free,” as well as to track and short-term or long-term side effects to treatment. Someone who has had a cancer diagnosis will need to be more diligent with their cancer screenings to ensure that their treatment is working, or to determine early if the cancer has spread or come back.

Digital Stories

Mathew DuBois: A Native American Lung Cancer Survivor's Message on Screening
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Mathew DuBois: A Native American Lung Cancer Survivor's Message on Screening
:30 PSA

 

Bridging Gaps in Rural Cancer Care:  The Importance of Patient Navigation in the UP

 

Native American Health:  The Life-Saving Power of Breast Cancer Screening

additional Resources

The following public health and medical resources address screening and follow-up regarding different types of cancer, and health insurance coverage issues for the AI/AN demographic.

Breast Cancer

1. Journal of Health Disparities and Practice (PDF)
   Breast Cancer Screening Practices among American Indians and Alaska Natives in the Midwest
2. American Cancer Society
   Follow-up Care After Breast Cancer Treatment

Cervical Cancer

1. GW Cancer Center
   Gynecological cancer refers to any cancer that originates in a female reproductive organ, such as ovarian, cervical, uterine/ endometrial, vaginal, and vulvar cancers.  These cancers have varying symptoms, and as screenings are not available for these cancers except for cervical cancer, it is important for patients and providers to understand and recognize the symptoms for each.  This health awareness campaign can help your organization implement evidence-based practices when communicating about gynecological cancer.
   Gynecological Cancer Awareness Campaign
2. National Native Network and Inter-Tribal Council of Michigan
   Pap-A-Thon Toolkit:  Hosting a Women's Community Health Event - Increasing Cervical Cancer Screening in Rural Tribal Communities
3. American Society for Colposcopy and Cervical Pathology
   Management Guidelines
4. Journal of Health Disparities Research and Practice (PDF)
   Pap Test Follow-up Pattern Among American Indian Women in Arizona

Colorectal Cancer

1. American Indian Cancer Foundation (PDF)
   Improving Northern Plains American Indian Colorectal Cancer Screening
2. Mona Sarfaty, MD (PDF)
   How to Increase Colorectal Cancer Screening Rates in Practice: A Primary Clinician's Evidence-Based Toolbox and Guide, 2008
3. Clinician's Reference (PDF)
   Fecal Occult Blood Testing (FOBT) For Colorectal Cancer Screening
4. Indian Health Services (PDF)
   Strategic Plan to Increase Colorectal Cancer Screening Among American Indians and Alaska Natives
5. Cancer.net
   Follow-up Care of Colorectal Cancer
6. American Gastrointestinal Institute (PDF)
   Guidelines for Colonoscopy Surveillance after Screening and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer
7. American Cancer Society (PDF)
   Colorectal Cancer Facts & Figures, 2014–2016
8. CDC Infographic
   Screening for Colorectal Cancer
9. Journal of Community Engagement and Scholarship
   Partnering to Reduce Colon Cancer Health Disparities Among the American Indian Population in Michigan

Lung Cancer

1. U.S. Preventive Services Task Force
   Final Recommendation Statement | Lung Cancer: Screening
2. American Cancer Society Journals
   Lung Cancer Screening Guidelines:  Smoking matters, not quitting
3. Centers for Disease Control and Prevention
   Screening for Lung Cancer

Sample Policies

1.  Wah-Zha-Zhi Health Center
   Provider Reminders Protocol for Cancer Screenings
2. Wah-Zha-Zhi Health Center
   Patient Reminders Protocol for Cancer Screenings
3. St. Croix Tribal Health Department
   Adult Preventative Care Timeline 2018