Patterns of Care among Native Americans

Relatively limited information is available and even less appears in published form that provides a profile of contemporary cancer care among Native American populations. There have been dramatic changes in the health care delivery system for Native American tribes. This is coupled with significant cultural aspects of cancer as a health concern among Native populations.

NCI is funding studies for patterns of care similar to projects currently supported under the special studies mechanism of the SEER Program. Data have been combined from several sources, including SEER and the Indian Health Service (IHS), augmented by abstracted data from medical records in a sample of cancer patients. The study is proceeding with input and oversight from NCI and IHS staff, SEER investigators, as well as tribal medical directors. Information has been gathered on possible barriers to early diagnosis, such as type of insurance coverage, distance to medical center, and treatment compliance or refusal for Native Americans living in New Mexico and Arizona.

The first project focused on the linkage of SEER and IHS data files to evaluate the completeness and quality of data elements. This entailed identifying Native American cancer cases and examining the data items available and their consistency across data systems. Other databases, such as Blue Cross/Blue Shield and Medicare/Medicaid, were considered as potential sources for additional information. In another project, NCI is supporting a Native American researcher in a collaborative effort to obtain patterns of care information in South Dakota. The investigator has met with relevant tribal and state health department officials during the planning phase of this project.