Urban-based Native American cancer-control activities: Services and perceptions

Background. Cancer has become a significant health concern in American Indian communities. Over the past several decades Native peoples have experienced significant increases in life expectancy and, with these gains, significant increases in cancer incidence and mortality. Limited data are available concerning cancer-control activities accessible to American Indian communities. Even less is known about control programs in place for American Indians resident in urban areas, where more that half of all Native peoples reside. Methods. To ascertain the extent of available services and perceptions of health directors, a survey of all Indian-Health-Service- recognized urban clinics was undertaken. Results. Results indicate that the cancer needs of American Indians resident in urban areas are not being adequately addressed. Only one-third of urban health directors reported perceived increases in cancer incidence and mortality rates. The directors ranked cancer fifth among seven health problems in terms of their clinics' commitment to addressing them. Findings from this study are juxtaposed with whose obtained in a separate survey of reservation-based health directors. Conclusions. Results indicate a need to develop more responsive cancer- control programs in Indian country and to sensitize researchers to other health needs of these communities.