Nationwide Study Finds Higher Rates of Cancer Mortality, Increasing Cases of Early-Onset Colorectal Cancer Among American Indian and Alaska Native Individuals

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New findings revealed that overall cancer mortality among American Indian and Alaska Native patients was 18% higher than among White patients despite similar cancer incidence, according to a new study published by Kratzer et al in CA: A Cancer Journal for Clinicians. The findings included the first nationwide mortality data published for this population.

This disparity was shown to be driven by common cancers that are receptive to early detection. For example, breast and prostate cancer incidence rates were 15% and 12% lower among American Indian and Alaska Native individuals compared to White individuals, whereas mortality rates were 8% and 31% higher, respectively.

Study Details

The study authors comprehensively compared cancer incidence and mortality among non-Hispanic American Indian and Alaska Native individuals with non-Hispanic White individuals.

The results showed that overall cancer incidence rates among American Indian and Alaska Native individuals were 2% higher than those among White individuals, but 18% higher for mortality. However, disparities varied widely by geographic region and cancer type.

Notably, colorectal cancer incidence and mortality rates were both approximately 40% higher among American Indian and Alaska Native individuals than those among White individuals overall, but among Alaska Native individuals specifically, incidence was 2.5 times higher. The researchers determined that this disparity was being exacerbated by steeper rates of early-onset colorectal cancer—rates that have risen by 85% between 1998 and 2018 among Alaska Native individuals aged 20 to 49 years (representing an increase from 18.8 to 34.8 cases per 100,000 individuals) vs 33% among White individuals (from 9.4 to 12.5 cases per 100,000 individuals).

The mortality rates for infection-related cancers (hepatic, gastric, and cervical)—as well as renal cancer—were approximately twice as high among American Indian and Alaska Native individuals compared with those among White individuals.

“Our report shows that the American Indian and Alaska Native community is disproportionately impacted by cancers that are either preventable or detectable early, when treatment saves lives. These findings highlight the need for more effective strategies to reduce the prevalence of chronic oncogenic infections and improve access to high-quality cancer screening and treatment for this group of individuals,” said lead study author Tyler B. Kratzer, MPH, Associate Scientist II of Cancer Surveillance Research at the American Cancer Society (ACS). “Mitigating the disparate burden will require expanding financial support of tribal health-care as well as increased collaboration and engagement with this marginalized population,” concluded Dr. Kratzer.”

Disclosure: The research in this study pulled population-based data from the National Cancer Institute (NCI), the Centers for Disease Control and Prevention (CDC), and the North American Association of Central Cancer Registries (NAACCR). For full disclosures of the study authors, visit

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.