Cancer and American Indian and Alaska Native People

Overview

Non-Hispanic American Indian and Alaska Native people have higher rates of getting certain kinds of cancer than non-Hispanic White people. They have been the subject of centuries of systemic racism, which has often resulted in less access to health care, healthy food, and educational and employment opportunities.

These types of inequities have contributed to many health disparities, including higher cancer rates, across American Indian and Alaska Native tribes and between American Indian and Alaska Native people and people of other races and ethnicities. Eliminating these inequities can improve health outcomes for these populations.

Cancer rates

The rates of getting and dying from certain kinds of cancer can vary widely among American Indian and Alaska Native people in different areas of the United States. For example:

• Lung cancer is the most common cancer among non-Hispanic American Indian and Alaska Native populations in five of the six Indian Health Service (IHS) regions in the United States. And in the Southwest region, lung cancer is the fourth most common cancer, after colorectal, kidney, and liver cancer.
• Stomach cancer is the fourth most common cancer among non-Hispanic American Indian and Alaska Native people in Alaska but the sixth most common cancer among this population in the Southwest region. Stomach cancer is not among the top 10 most common cancers among non-Hispanic American Indian and Alaska Native people in other regions.
• The overall rate of getting cancer is more than twice as high among non-Hispanic American Indian and Alaska Native people in the Southern Plains region (612 per 100,000 people) compared to the Southwest region (294 per 100,000 people).

Compared to non-Hispanic White people, non-Hispanic American Indian and Alaska Native people have different rates of getting some kinds of cancer. For example:

• Non-Hispanic American Indian and Alaska Native women have higher rates of getting cervical cancer than non-Hispanic White women in all regions except the East region.
• Non-Hispanic American Indian and Alaska Native males and females have higher rates of getting colorectal, kidney, and stomach cancers than non-Hispanic White males and females in almost all regions.
• In all regions, non-Hispanic American Indian and Alaska Native people have higher rates of getting liver cancer than non-Hispanic White people.
• Non-Hispanic American Indian and Alaska Native men have lower rates of getting prostate cancer than non-Hispanic White men in all regions except the Northern Plains and the Southern Plains.

Data source: United States Cancer Statistics: Data Visualizations. Data are restricted to non-Hispanic American Indian and Alaska Native people living in IHS purchased/referred care delivery area counties.

Risk factors

Many cancers can be prevented. Staying away from commercial tobacco smoke, keeping a healthy weight, and drinking little or no alcohol can lower a person's risk of getting cancer. Screening tests can prevent some cancers or find them early, when treatment works best.

Note: Commercial tobacco means products that are made and sold by tobacco companies. It does not include traditional tobacco used by Indigenous groups for religious or ceremonial purposes.

A risk factor is something that may increase a person's chances of getting cancer. American Indian and Alaska Native people in the United States have a higher prevalence of some risk factors compared to White people. For example:

• Obesity is more prevalent among non-Hispanic American Indian and Alaska Native adults than non-Hispanic White adults.
• On average, American Indian and Alaska Native people are more likely to smoke cigarettes than members of other racial or ethnic groups in the United States.
• American Indian and Alaska Native people have the highest rate of getting chronic hepatitis C, which can lead to liver cancer.
• The prevalence of Helicobacter pylori (H. pylori)—a type of bacteria that can lead to stomach cancer—is particularly high among Alaska Native people.
• Non-Hispanic American Indian and Alaska Native people are less likely than non-Hispanic White people to be up to date on cancer screening tests, according to the IHS's 2021 Government Performance and Results Act report.

Note: In the statistics above, some comparisons are only between race categories, while others are between race and ethnicity categories (non-Hispanic or Hispanic).

Improving access to care

Compared to non-Hispanic White people in the United States, American Indian and Alaska Native people generally find it harder to get medical care. They often face the following barriers:

• Lack of health insurance. A higher percentage of non-Hispanic American Indian and Alaska Native people are uninsured than members of other races.
• Lower household incomes. In 2019, the median household income for American Indian and Alaska Native people was $49,906, compared to $71,664 for non-Hispanic White households.
• Lower educational attainment. In 2019, about 84% of American Indian and Alaska Native people had at least a high school diploma, compared to about 93% of non-Hispanic White people.
• Remote locations. American Indian and Alaska Native people who live on reservations and in rural areas often find it hard to get health care. They may live far from a screening facility and have little or no access to public transportation.

What CDC is doing

• Accurate cancer data can help expand services: Many American Indian and Alaska Native people are misclassified as another race in cancer registry records. A unique collaboration between the cancer surveillance community and the IHS reduces this misclassification.
• Data help find cancer disparities: This blog post explains how CDC field assignee epidemiologists are working to understand why cancer rates differ across American Indian and Alaska Native communities and find ways to help them prevent cancer.
• Cancer in American Indian and Alaska Native people: American Indian and Alaska Native people have higher rates of getting some cancers compared to non-Hispanic White people. Researchers compared cancer rates in six regions across the country.

Success stories

• Tribal Program Increases Breast Cancer Screening Despite Pandemic: This story is an example of how an award recipient in CDC’s National Breast and Cervical Cancer Early Detection Program helped American Indian women get mammograms.
• Blue Beads Campaign Teaches American Indian Community About Colorectal Cancer: An award recipient in CDC’s National Comprehensive Cancer Control Program partnered with nine tribal and urban Indian health clinics to increase colorectal cancer screening.

Note: The Office of Management and Budget defines an American Indian or Alaska Native person as "A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment." The Bureau of Indian Affairs recognizes 574 tribal entities in the continental United States and Alaska.