While life expectancy for Alaska Natives continues to grow, some kinds of cancer remain persistent

By Yereth Rosen, Arctic Now - November 6, 2017
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Life expectancies for Alaska Natives are inching up, but so too is the prevalence of certain kinds of cancer, and cancer death rates remain far higher than for non-Natives, according to a wide-ranging status report released by the Alaska Native Tribal Health Consortium.

The second edition of the Alaska Native Health Status report showed some important improvements for Alaska’s indigenous peoples — but it also showed some persistent gaps between the welfare of Alaska Natives and that of the non-Native population in Alaska and the United States.

The numbers collected tell “only a small part of the story,” the report said. Some data might not be readily available, and some information is not easily conveyed in numbers, it said. “Nevertheless, the data provides a small snapshot of where we are and can help guide advocacy, policy making, program planning, and program evaluation,” it said.

Alaska Natives’ life expectancy was 70.7 years by 2013, the document reports, compared to 79.1 years for U.S. whites. The gap is has narrowed since the early 1980s, when average Alaska Native life expectancy was 65.3 years, according to the report.

The leading cause of death for Alaska Native people is cancer, followed by heart disease and unintentional injury, the report said. In comparison, the leading cause of death for non-Native Alaska whites is heart disease.

Cancer death rates for Alaska Natives did not decline from the 1980s to 2015, even though rates for the non-Alaska Native population did fall during that period, the report said. Rates of cancer mortality are much higher for Alaska Natives than for non-Native Alaskans or U.S. whites; as of 2015, the cancer death rate for Alaska Natives was more than 50 percent higher than that for non-Native Alaskans, the report said.

The ANTHC report found that four types — breast, lung, colorectal and prostate — account for more than half the cancer cases among Alaska Native people. Lung cancer tops the list for men and breast cancer tops the list for women.

Colorectal cancers are the second-most frequent type of cancer for Alaska Native people, the report pointed out. An earlier ANTHC health report, a 45-year review of cancer incidences among Alaska Natives that was released in 2016, found that colorectal cancer rates were about twice as high as those for US whites. The Arctic Slope region has the state’s highest incidence rates for lung cancer and colorectal cancers among Alaska Native people, the 2016 report said.

Alaska Native health organizations have stepped up their efforts to detect colorectal cancers early. There have been educational events and displays, health providers have used text messages to remind Alaska Native patients to get screenings.

Those efforts appear to have been effective.

 By 2015, about 74.4 percent of Alaska Native 50 and older had had some type of colorectal cancer screening, compared to 70.7 percent of U.S. whites in the same age group, the new health status report said. Alaska Natives’ screening rate for colorectal cancers increased almost three-fold from 1992 to 2015, the report said.

Because of the high prevalence of this type of disease, Alaska health providers recommend that colorectal cancer screenings start at age 40 for Alaska Natives, a decade earlier than what is recommended for non-Natives.

The usual screening procedure, colonoscopy, is difficult to do in rural Alaska and expensive. In response, health providers have promoted a less-costly and more convenient alternative test, which analyzes stool samples collected by patients and sent to a laboratory.

Greenland may benefit from Alaska’s example, according to analysis by researchers from Dartmouth. With environmental, cultural and geographic similarities to Alaska, Greenland also has a population at elevated risk for colorectal cancer rates.

Economic analysis by the Dartmouth researchers found that if all Greenlanders aged 40 and older traveled to the capital, Nuuk, for colonoscopies, that screening would eat up 7 percent to 8 percent of Greenland’s entire health budget. The stool test that is being used in Alaska would be much more cost effective, the Dartmouth analysis said.