New study finds Native youth with cancer have higher risk of death than non-Native counterparts

By Sejal Parekh, M.D.

Editor’s note: Dr. Sejal Parekh is a health equity media fellow at Stanford University. She worked as a pediatrician at Chinle Comprehensive Health Care Facility.

STANFORD, Calif. – A new study finds that Native American/Alaska Native young adults with cancer have a 15% higher risk of death than their white counterparts. This study was led by Dr. Kekoa Taparra, a Native Hawaiian radiation oncology doctor at Stanford University. He has seen how disparities in cancer care affect Indigenous populations.

A few years ago, Taparra watched his uncle wither from prostate cancer in Maui, unable to access the cancer center on a neighboring island.

“It’s not just a matter of getting in a car and driving down the road,” said Taparra. To access treatment, his uncle would have to jump through numerous logistical hoops–like buying a plane ticket and finding lodging–in hopes of eventually getting to see the right doctor.

Taparra’s uncle is not alone. Native American/Alaska Native young adults were 52% more likely to be diagnosed with testicular cancer at a later stage compared to their white counterparts. Native American/Alaska Native patients also had the lowest 10-year overall survival rate in lung, brain, ovarian, and testicular cancers.

There are many reasons why one group of people might have higher death rates from cancer. The cancer could have been caught late, and already have spread to other parts of the body. However, Taparra said this was not the case for many Native young adults 15-39 years old enrolled in the National Cancer Database from 2004 to 2017.

Taparra believes that lack of access to cancer care is one of the main reasons that Native American/Alaska Native, and Native Hawaiian/Pacific Islander young adults suffered disproportionately high death rates at 10 years from diagnosis.

Cancer treatment is often provided at large, academic centers. Taparra said that recent studies “have found geographically, the American Indian and Alaska Native populations, especially on tribal lands, are very isolated from these larger cancer centers.”

What you can do to catch cancer early

Dr. Melissa Simon is an OB-GYN doctor at Northwestern University who works with the Chicago Cancer Health Equity Collaborative. She said that there are several steps young adults can take to prevent or catch cancer early.

The most important is “to engage in an annual visit with your health care provider with primary care,” said Simon. At this visit, young adults can get the HPV vaccine, a shot that prevents cervical and oral cancer.

At an annual visit, young adults can also get screened for skin cancer. “Skin cancer is extremely common,” said Simon. “Sunscreen is important regardless of how melanized or how dark your skin is.”

Finally, Simon encourages young adults to talk to their family members to learn about their cancer risk. “If you don’t know your family history, that makes it a little more challenging to know what cancers you might be more vulnerable to, or have a higher risk of getting,” she said.

If a young adult is diagnosed with cancer, Simon encourages them to ask about new treatment options. “It is standard of care to be offered clinical trials if they are available for you. And it is your right to decline, but it’s also your right to participate, and it’s also your right to ask,” said Simon.

Many people are wary of clinical trials, and for good reason. Simon acknowledges that medical systems “have broken that trust and we’ve got to work super hard to earn the trust back.”

However, she said, “These days, trials are under a lot more scrutiny than they ever have been with respect to informed consent, with respect to full transparency of disclosure of what will happen during the trial.”

“We have good data that show if you participate in clinical trials, your health care is actually better and your health care outcomes, specifically in cancer, are better,” she said.

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