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Native American Initiatives:
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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.
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