Reports at both the state and national levels indicate that the overall cancer burden among American Indians has been lower for all-causes, and for breast, lung and colon cancer specifically, while higher rates have been found for cancers of the stomach, gallbladder and pancreas. Recent national reports of cancer incidence have shown increasing rates of some cancers among American Indians, such as cervical and breast cancer, coupled with poor survival rates, late stage diagnosis, poor access to care and/or cultural barriers. Arizona ranks third nationwide in the total number of American Indian residents (282,468 in 2004). In Arizona there are 21 federally recognized tribes each with its own history and culture and governmental organization. The Hopi Nation is one such tribe which has been located in the northeast part of Arizona for thousands of years and currently includes approximately 10,000 people. Hopi Health Department officials and community members have recently expressed interest in quantifying the cancer burden of the Hopi people so that prevention and control programs can be developed and implemented to fit their tribal-specific needs. The Arizona Cancer Registry (ACR) - the state mandated population based registry - maintains and validates racial classification in its database; however, tribal affiliation is not captured. Attribution of statewide data on all American Indians to the tribal level assumes inter-tribal homogeneity and use of these aggregate data does not allow specific tribes to assess their own needs or the cancer burden for tribal members residing off reservation. The ACR and one other Native American tribe in Arizona have jointly generated a table of that tribe's cancer cases for use by the tribal health department. With this grant, a partnership between the Arizona Cancer Center at the University of Arizona, the Hopi Tribe's Office of Health Services and the ACR of the Arizona Department of Health Services (ADHS) will be formed to quantify the magnitude and scope of the cancer burden among all Hopi tribal members regardless of residency. We will test the hypothesis that the burden of cancer among the Hopi is indeed different than that reported for all American Indians in the State of Arizona. We will also increase the capacity of the Tribe to evaluate its own cancer data. With this process, we hope to establish a model for identifying, obtaining and analyzing tribal specific data to be used by other tribal nations in the State of Arizona. ? ? ?
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