Natives Are Three Times More Likely To Die From Various Cancers Warns American Cancer Society

Information board for CRNA's Tobacco Quit Line at 
Robert Marshall Clinic in Tazlina (Journal photo, June, 2021)

Cancer incidence rates higher for American Indians, Alaska Natives 

From Indian Country Today   By: Pauly Denetclaw

In the United States, American Indian and Alaska Native populations have higher cancer incidence rates in comparison to other populations. They’re also up to three times more likely than White people to die from kidney, colon, liver, lung, stomach and cervical cancers, according to a 2025 report by the American Cancer Society.  

American Indians and Alaska Natives have a higher prevalence of four risk factors that increase the risk of cancer. Healthy lifestyle changes and vaccines could help reduce risk. For others, it would be important to get tested for HPV and hepatitis C. 

Cancer is a term used for multiple diseases, but is defined as the uncontrollable growth of genetically damaged cells. These damaged cells are immature and cannot perform their assigned role. They also create and grow tumors. Cancer cells can develop in any part of the body. 

For example, stomach cells are assigned to break down food and absorb nutrients. Cancer cells in the stomach wouldn’t be able to perform any of these roles, it would create tumors that would hinder the stomach’s normal functioning and could influence healthy cells to provide nutrients for the tumors. 

While cancer prevention is important, it cannot address family genetics, environmental factors, and systemic racism, which also impacts cancer rates in American Indian and Alaska Native people. 

“You have environmental toxins from mining, you have illegal waste, agricultural runoffs, which I think in some ways are disproportionately affecting Native populations based on some of the data that I’ve read, and that can lead to downstream effects like cancer development,” said Dr. Christopher Chen, medical director of community practices at the City of Hope Cancer Center Phoenix. 

While there is medical care for cancer when it does develop, Chen says the resources can be stretched thin and challenging. 

“Indian Health Services is a great service, but just like any other government agency, it always faces funding and staffing issues,” Chen said. “These budgets and staffing issues limit access to care.”  

Risk factors and cancer prevention 

American Indian and Alaska Native people have a higher prevalence of some risk factors for cancer. They include obesity, regular use of commercial tobacco for non-ceremonial purposes, chronic hepatitis C, and a high prevalence of H. pylori which is a bacteria that causes ulcers and inflammation of the stomach lining, according to a 2025 American Cancer Society report.

Obesity increases the risk for 13 different types of cancer, according to the Centers for Disease Control and Prevention. They are cancers in the colon, rectum, female breast post-menopause, esophagus, uterus, gallbladder, upper stomach, kidneys, liver, ovaries, pancreas, thyroid, multiple myeloma and the tissue that covers the brain and spinal cord. 

“The foods we eat impact the biome of the stomach environment, and it’s a risk for developing certain cancers. So how do we optimize, in a preventative setting, people’s diets?” Chen said. “But it ties back into socioeconomics. Sometimes you don’t have a choice of what you want to eat, and then what you’re able to eat.”

For those who don’t have easy access to grocery stores, buying frozen fruits and vegetables is one way to add more healthy foods, according to Dignity Health, a national nonprofit health care organization.  Dollar Tree, Dollar General and Family Dollar offer a limited selection of frozen produce. With high grocery prices, another way to lower food cost is buying produce that is in season or on sale. The U.S. Department of Agriculture has a list of produce and when they are in season. Most grocery stores have a weekly advertisement that lists all of the on-sale produce and meats. 

When looking at packaged foods, Dignity Health recommends looking at the nutritional label and selecting items that have under 600 mg of sodium, more commonly known as salt, and have less than 12 g of sugar per serving. 

Moving the body and sleep are key, too. 

“Having a healthier lifestyle and maintaining an active lifestyle, where people are exercising regularly,” Chen said. “Having regular meals — that’s something we almost never talk about. Good sleep hygiene. How many people are actually getting seven to eight hours of sleep every night?” 

Lung cancer is the most common cancer in five of the six IHS regions. 

“Among [American Indian and Alaska Native] people, who have the highest lung cancer rates, incidence has yet to decline in women, underscoring the need to redouble culturally sensitive, targeted tobacco-control efforts,” the American Cancer Society report stated. 

For some tribal nations, smoking tobacco is part of cultural ceremonies or is used as an offering during prayer. When talking about lifestyle changes, it doesn’t include ceremonial, spiritual or cultural use of tobacco. Limiting the habitual use of commercial tobacco for recreational purposes is recommended. 

“People know that smoking [cigarettes] is not good for you,” Chen said. “Currently there’s no big data sets for vaping, there’s no proof of harm yet. But you go back 40, 50 years, there wasn’t proof of harm yet for cigarettes. Right now, I worry about the younger population using vaping devices.”    

Alaska Natives have a higher prevalence of the stomach cancer causing bacteria, H. pylori. It is a common stomach bacteria that more than half of the world’s population will contract at some point in their lives, according to the Mayo Clinic. It can be spread by sharing food or utensils with a person who has H. pylori. It can also be spread through tainted food and water. The infection can be treated with antibiotics. The signs and symptoms include stomach pain, bloating, gas and peptic ulcers. 

Nationally, American Indian and Alaska Native people have the highest risk of chronic hepatitis C, which can lead to liver cancer. Hepatitis C is a virus that spreads through blood to blood contact. People that are at higher risk of contracting this virus should get tested. It can be treated with 12 weeks of antiviral medicines. 

The more alcohol a person drinks the higher chance they will get liver cancer, according to the American Cancer Society. They recommend not drinking alcohol at all. People who choose to drink shouldn’t have more than one drink per day. Alcohol use has been linked to mouth, throat, liver, colon, breast and stomach cancer.

“The data I’ve read is that alcohol consumption rate is actually lower in Native populations, but the rate of heavy usage is higher,” Chen said. “There’s less people who drink, but the people who drink tend to drink heavier, and it’s the high consumption of alcohol that really puts patients at risk for developing issues in their liver and other health related issues down the road.”

HPV, cervical cancers

The risk of several cancers can be reduced by getting the HPV vaccine. There are two types of HPV, wart-causing, also known as, non-oncogenic, and cancer-causing, or oncogenic. It takes years, if not decades, for a person to develop cancer after being exposed to HPV.

Genital HPV is the most common sexually transmitted virus and it can cause cancers of the cervix, penis, anus and throat. The virus typically has no symptoms and will clear up on its own in around two years. Women and people assigned female at birth can get an HPV test which uses a similar procedure to a pap smear. Pap smears are recommended every three years and test for cervical cancer or cell changes that may turn into cancer. 

The vast majority of cervical cancers are caused by HPV and almost all cervical cancers can be prevented by the HPV vaccine. Nearly 11,000 women and people with cervixes are diagnosed with cervical cancer caused by HPV every year and around 4,000 die from cervical cancer, according to the Center for Disease Control. 

“A lot of cervical cancers originate from HPV infections,” Chen said. “If you can limit the infection rates by the adoption of HPV vaccines, down the road, you’ll have less HPV related cancers.”

HPV also impacts men and people assigned male at birth. About 16,000 get diagnosed with cancers caused by HPV every year. There are no FDA-approved tests for HPV in people with a penis. They often don’t show any symptoms despite having the virus, and diagnosis can only be made based on visual examination of warts or lesions. 

These are just a few of the ways to try and prevent cancer.