1. Examples of American Indian Alaska Native Cancer Patterns Linda Burhansstipanov, DrPH (Cherokee Nation of Oklahoma) Native American Cancer Research 393 South Harlan Street, suite 125 Lakewood, CO 80226-3571 303-325-3377; fax: 303-495-3040 http://www.NatAmCancer.org Native American Cancer Research 800-537-8295; http://www.NatAmCancer.org

2. Pre-Training Knowledge4 Items Native American Cancer Research ARS polling question

3. Which of the following health problems (co-morbidities) are present in 15-25% of AIAN cancer patients? • Lupus Arthritis • Heart disease • Diabetes • Stroke • Don’t know / Not sure pa1-comorbidity-1 Native American Cancer Research ARS polling question 0 / 175

4. What percentage of AIAN women are younger than age 50 at the time they are diagnosed with breast cancer? • 15% • 25% • 35% • 50% • Don’t know / not sure b1-age-dx-4 Native American Cancer Research ARS polling question 0 / 250

5. What geographic region of Indian Country has the most significant problem with stomach cancer? • Southwest • Northwest • Northern Plains • Southern Plains • Northeast • Southeast • Don’t know / not sure pa1_stomach-2 Native American Cancer Research ARS polling question 0 / 250

6. Where are oncologists based within Indian Health Service / Tribal / urban clinical settings? • Phoenix • Anchorage • Oklahoma City • Seattle • Los Angeles • Portland • New York • Don’t know / not sure pa1_oncologist-3 Native American Cancer Research ARS polling question 0 / 250

7. Workshop Objectives: By the end of the session, the participant will be able to: • Identify unique characteristics and differences of AIAN cancer patterns in comparison to other racial groups.

8. Examples of Different Patterns of Cancer Sites and Access (cont.) • Average age of AIAN population is younger in comparison to US All Races and our people are diagnosed at younger ages • ½ of AIAN breast patients younger than 50 • Co-morbidity • 15%-25% of AIAN cancer patients are diabetic

9. Examples of Different Patterns of Cancer Sites and Access (cont.) • Access to cancer resources outside of IHS / Tribal / Urban clinical settings insufficient or non-existent • ½ of AIAN cancer patients fight for Medicaid (young at time of dx) or Medicare)

10. Examples of Different Patterns of Cancer Sites and Access (cont.) • Access to cancer resources (continued) • 64+% of AIANs live in urban areas of which there are only two I/T/U cities that provides cancer care: • Anchorage • Fairbanks

11. What part of the country do you think prostate cancer has the highest deaths for AIAN men? • Alaska • Southwest • Northwest • Northern Plains • Southern Plains • Northeast • Southeast • Don’t know / Not Sure pa1_prostate-10 0/0

12. Examples of Different Patterns of Cancer Sites and Access (cont.) • Different Types of Cancer by Geographic Region and Tribal Nation; such as: • Prostate cancer among northern plains comparable to African Americans and whites • More stomach, kidney and gallbladder among southwestern tribal nations • More CRC, breast and lung among AK, northern plains and southern plains

17. Interactive Activity

18. Bear / Coyote 1. Stomach cancer is more common among Northern Plains American Indians in comparison to Natives living in other parts of the country False / Coyote

19. Bear / Coyote 2. Prostate cancer is more common among Northern Plains American Indians in comparison to Natives living in other parts of the country True / Bear

20. Bear / Coyote 3. About 25% of White women are diagnosed with breast cancer prior to age 50, but about half of AIAN women are diagnosed with breast cancer prior to age 50. True / Bear

21. Bear / Coyote 4. About 15-25% of AIANs diagnosed with breast cancer also have diabetes. True / Bear

22. Bear / Coyote 5. About ½ of all AIANs diagnosed with cancer have to fight to get Medicaid or Medicare benefits. True / Bear

23. Bear / Coyote 6. The only clinic that has an oncologist on staff throughout Indian Country is at the Alaska Native Medical Center in Anchorage, AK True / Bear

24. Which of the following health problems (co-morbidities) are present in 15-25% of AIAN cancer patients? • Lupus Arthritis • Heart disease • Diabetes • Stroke • Don’t know / Not sure pa2-comorbidity-1 Native American Cancer Research ARS polling question 0 / 175

25. What percentage of AIAN women are younger than age 50 at the time they are diagnosed with breast cancer? • 15% • 25% • 35% • 50% • Don’t know / not sure b2-age-dx-4 Native American Cancer Research ARS polling question 0 / 250

26. What geographic region of Indian Country has the most significant problem with stomach cancer? • Southwest • Northwest • Northern Plains • Southern Plains • Northeast • Southeast • Don’t know / not sure pa2_stomach-2 Native American Cancer Research ARS polling question 0 / 250

27. Where are oncologists based within Indian Health Service / Tribal / urban clinical settings? • Phoenix • Anchorage • Oklahoma City • Seattle • Los Angeles • Portland • New York • Don’t know / not sure pa2_oncologist-3 Native American Cancer Research ARS polling question 0 / 250

28. Give Yourself a Hand!