Cancer in American Indian Women: Key Points

Vital Statistics and Social Indicators

• There are almost 2.5 million self-identifying American Indians/Alaska Natives in the United States. (About 106,000 of these are Alaska Natives, a population whose health data have often been combined with data about American Indians.)
• There are about 825,000 American Indian adult women. (There are about 1.5 million, including those of mixed race.)
• Access to health care is determined for most American Indians by where they live and by their degree of Indian blood or tribal enrollment.
• The age distribution of American Indian women is skewed toward younger age groups, with 38 percent aged 19 or younger, according to the 1990 Census.
• Life expectancy rates for American Indian women lag behind those of other women in the United States.
• Because of the high mortality rates for American Indian men, many women are single parents and heads of households, and many live with their families in poverty.
• Sixty-five percent of American Indian women completed high school, according to the 1990 Census, compared with 77.9 percent of White women.

Cancer Rates, Mortality, and Risk Factors

• Data show that American Indians have lower rates than the general U.S. population for all cancers combined and for cancers of the lung, breast, and colon, though they have higher rates for other cancers, such as stomach cancer and gallbladder cancer.
• Cancer is the second leading cause of death for American Indian women.
• Breast, lung, and colorectal cancers are among the most commonly diagnosed in American Indian women.
• For all cancers combined and various site-specific cancers, the 5-year cancer survival rate for American Indian women is significantly lower than that for White women.
• Although the incidence and mortality trends among Native American women for most cancers have shown decreases during the 1990s, the proportional decreases are less than those for White women.
• Health care providers frequently cite space and time limitations and their own lack of interest as barriers that prevent them from performing cervical and breast cancer screening.
• There are great variations among tribes and regions in the number of cancer cases and the prevalence of behavioral risk factors.
• The major cancer risk factors for American Indian women include: tobacco use, poor diet, obesity, and inadequate screening for cervical and breast cancer.

Data Limitations and Future Directions

• Cancer data on American Indian women have several significant limitations, such as limited geographical coverage; racial misclassification and combining of tribes; and insufficient numbers from which to draw reliable conclusions.
• Recent cancer prevention and control initiatives have demonstrated that culturally sensitive interventions involving American Indian communities can improve cervical cancer screening rates, reduce smoking, and improve diets.
• Development of well-managed national data sources, such as tumor registries, could allow for key comparisons between urban and rural American Indian populations and populations across tribes, which in turn could enlighten researchers about cancer causes among American Indians and the best prevention strategies to serve this population.