On October 14, 2024, we observe Indigenous Peoples’ Day, a time to honor the culture, history, and contributions of Native American, Alaska Native, and other Indigenous communities across the United States. This holiday serves as a counter-narrative to Columbus Day, acknowledging the deep legacy of colonization and oppression that these communities have endured, while celebrating their resilience, rich heritage, and continuous impact on the nation.

Indigenous Peoples’ Day is not just a celebration of Indigenous culture; it is also a call to action to address the unique challenges these communities face, including health disparities such as cancer. Like many other marginalized groups, Native Americans experience disproportionate health risks and access barriers to adequate care, particularly in cancer prevention, diagnosis, and treatment.

Cancer has become one of the leading causes of death in Indigenous communities, with a growing number of cases reported each year. The disparities in cancer outcomes among Native Americans are alarming, as these populations face significantly higher mortality rates compared to other racial and ethnic groups in the U.S. According to the American Indian Cancer Foundation, cancer incidence rates are rising in some regions, particularly in rural areas, and Native Americans are often diagnosed at later stages, leading to poorer outcomes.

Key Factors Contributing to Cancer Disparities in Indigenous Populations:

1. Lack of Access to Healthcare
   Indigenous communities often reside in remote or rural areas where healthcare facilities are scarce. The lack of access to cancer screening and early detection services means that many Native Americans are diagnosed at later stages of cancer, when the disease is harder to treat. The Indian Health Service (IHS), the federal agency responsible for providing healthcare to Native American and Alaska Native communities, has been historically underfunded, further compounding the problem.

2. Cultural Barriers and Trust in the Healthcare System
   Many Indigenous people experience cultural barriers and mistrust of the healthcare system, often due to a long history of mistreatment, discrimination, and lack of culturally sensitive care. This mistrust can result in delayed or avoided medical care, including cancer screenings. Cultural differences, such as language barriers and traditional healing practices, may also contribute to these delays.

3. Socioeconomic Inequities
   Indigenous communities face high levels of poverty, unemployment, and lower levels of education. These socioeconomic factors directly affect access to health insurance, healthcare resources, and the ability to afford treatment. The combination of these challenges means that Indigenous people often do not receive the same level of cancer care as other Americans.

4. Higher Risk Factors for Certain Types of Cancer
   Native Americans are at an increased risk for several cancer types, particularly cancers linked to tobacco use and alcohol consumption. Lung cancer, for instance, is one of the most prevalent forms of cancer among Indigenous populations due to high smoking rates. Likewise, liver cancer incidence is higher due to the prevalence of hepatitis C and alcohol-related liver disease in some Native communities.

5. Environmental Factors
   Many Native American communities are situated near environmentally hazardous sites, including uranium mines, contaminated water sources, and industrial pollution zones. Exposure to carcinogens from these sources has been linked to elevated cancer rates, particularly in areas with mining activities. For example, Navajo Nation residents have suffered higher rates of cancer due to long-term exposure to uranium from abandoned mines.

Cancer Statistics in Indigenous Communities

• Breast cancer is the most common cancer among Indigenous women, yet they are more likely to be diagnosed at advanced stages, leading to lower survival rates.
• Lung cancer rates are higher in Native American communities, particularly among men, due to higher tobacco use rates.
• Colorectal cancer also has a high incidence, with Indigenous people being less likely to receive routine screenings such as colonoscopies.
• Liver cancer disproportionately affects Native Americans, with higher rates attributed to the prevalence of hepatitis C and alcohol-related liver damage.

According to a report by the Centers for Disease Control and Prevention (CDC), Native Americans and Alaska Natives have lower five-year cancer survival rates compared to non-Hispanic white Americans. The disparities are more pronounced in certain regions, particularly in the Northern Plains and Alaska.

Efforts to reduce cancer disparities in Indigenous communities require a comprehensive, culturally sensitive approach that addresses both healthcare access and the social determinants of health. Here are some steps being taken to close the gap:

1. Community-Based Cancer Screening Programs
   Many Indigenous health organizations, such as the American Indian Cancer Foundation and Intertribal Health Organizations, are developing community-based programs to increase cancer awareness and screening rates. These programs focus on culturally tailored outreach efforts, ensuring that education about cancer risks, symptoms, and screening options is accessible and trusted by Indigenous communities.

2. Improving Access to Healthcare
   Expanding healthcare access through mobile clinics, telemedicine, and partnerships between Native healthcare organizations and larger cancer treatment centers is essential. Increasing funding for the Indian Health Service (IHS) is also a critical component of ensuring that Indigenous communities receive timely and comprehensive cancer care.

3. Culturally Competent Care
   Providing culturally competent care that respects Indigenous healing traditions while integrating modern medical treatments is key to building trust between Native patients and healthcare providers. This involves training healthcare professionals to understand the cultural values, histories, and practices of Indigenous people and fostering environments where patients feel safe and respected.

4. Tobacco Cessation and Cancer Prevention Programs
   Addressing risk factors such as tobacco use is essential to reducing cancer incidence in Indigenous communities. Culturally relevant tobacco cessation programs, supported by community leaders and health advocates, have been effective in promoting healthier lifestyles.

5. Research and Data Collection
   More research is needed to understand the unique cancer risks and outcomes among Indigenous populations. Improved data collection, including tribal-specific cancer registries, can help identify trends and provide the information necessary to develop targeted interventions.

Indigenous Peoples’ Day 2024 is not only a time to honor and celebrate the rich cultural legacy of Native American, Alaska Native, and other Indigenous communities but also an opportunity to address the ongoing health disparities they face, particularly in cancer care. As we continue to celebrate their contributions to society, we must advocate for equitable healthcare access, culturally competent care, and targeted cancer prevention strategies for these communities.

By raising awareness about cancer in Indigenous populations and working together to close the gap in healthcare access and outcomes, we can help ensure that future generations of Indigenous people can thrive.