Alaska Natives Hard-Hit by Quick-Killing Cancers
ANCHORAGE, Alaska (Reuters) - Alaska's Eskimos, Indians and Aleuts are more likely than American whites to die within five years from cancer because they tend to be stricken by cancers that are difficult to detect and kill quickly after diagnosis, accordi
Lung cancer and other smoking-related cancers are largely to blame, said one of the authors of the study, Dr. Anne Lanier, research director of the Alaska Native Tribal Health Consortium.
There is no evidence that Alaska Natives receive inferior cancer diagnosis or treatment, Lanier said. Survival rates for individual types of cancer are not much different here than elsewhere, she said.
"Cancer-by-cancer, we do well, and sometimes even better," she told Reuters in an interview. But the prevalence of quick-moving cancers that cannot be detected early, such as lung cancer, reduced overall chances of living five years after a cancer diagnosis, she added.
"So overall, we come out with a nasty survival rate," she said.
The study, released during the Association of American Indian Physicians' annual conference, was the first comprehensive study of Alaska Native cancer survival rates, tribal health consortium officials said.
Alaska Natives diagnosed with cancer between 1984 and 1994 had a five-year survival rate that was 11.3 percent lower than that of U.S. whites, according to the study.
Only 45.4 percent of Alaska Natives survived five years after their cancer diagnosis, compared with 56.7 percent of U.S. whites, the study said.
The high prevalence of lung cancer among Alaska Natives -- a population with a heavy smoking rate -- accounted for much of the difference, Lanier said.
Of the 597 Alaska Natives who succumbed to cancer between 1994 and 1998, lung cancer accounted for more than a third of the deaths and was the leading killer, according to another study co-authored by Lanier and released at the conference.
Extrapolated to the overall population, the record showed that Alaska Natives were 40 percent more likely to die from lung cancer during the period than U.S. whites, the study said.
Since tobacco was not readily available or widely used in Alaska until World War II, the explosion in lung cancer rates occurred later for Alaska Natives than for whites in the nation as a whole, Lanier said.
Decades ago, smoking was encouraged in rural Native villages, she said. The Eskimo Scouts, military personnel who guarded the Alaska coastline during World War II, got free cigarettes in their rations, for example.
Lanier said she interviewed elderly cancer patients who were told by their doctors during the 1950s tuberculosis epidemics to switch from smokeless tobacco to cigarettes.
"In the TB days, they certainly didn't want a lot of people spitting here or there," she said.
Incidents of lung cancer began to pop up much later, since the disease commonly has a latency period of 20 years or more, she said.
"We've grown from one case a year to at least 20," she said.
Forty-three percent of Alaska Native adults smoke, compared to about 20 percent for the country as a whole, Lanier said.
Alaska health officials can expect a similar explosion in the future of chewing-tobacco-related cancers, said Gretchen Ehrsam, a researcher with the Alaska Native Tribal Health Consortium and a co-author of the cancer-mortality study.
Alaska Native youths use smokeless tobacco at a higher rate than the national average, she said, and the latency period for resulting cancers is long.
Overall, cancer mortality rates are not declining for Alaska Natives, unlike the U.S. population as a whole, the mortality study said.
If rates remain constant, health-care managers can expect huge increase in cancer cases among Alaska Natives, Ehrsam said. That is because the population, with a current median age of 23, is expected to live far longer than previous generations, she said. In 1950, when cancer was considered rare among Alaska Natives, the life expectancy was 46, she said.
"Now Alaska Natives are living to 70, so there's a lot more Natives and they're getting older and they're getting to the age when they get cancer," she said.