American Indian; Barriers to care; Cancer — Diagnosis; Cancer – Prevention; Colon (Anatomy) — Cancer; Colorectal cancer screening; Community-based participatory research; Health education; Indians of North America; Rectum — Cancer


Oncology | Public Health | Race and Ethnicity


Colorectal cancer is a great concern for the American Indian/Alaska Native (AI/AN) community, as incidence and mortality rates remain high and screening rates stay low. We conducted interviews with community leaders (n=13) and with providers from the Indian Health Service (IHS), tribal clinics, and urban safety-net clinics (n=17) in Northeast Kansas and the Kansas City Metro Area to determine their understanding of needs and barriers to colorectal cancer screening among American Indians. Using a community-based participatory research (CBPR) approach for this pilot study, community leaders and providers identified similar needs, including: culturally-appropriate education about colorectal cancer and screenings, the potential use of Native elders as patient navigators, and an emphasis on preventive care, particularly through the IHS. Barriers included culturally specific issues such as historic mistrust and gender roles. Other barriers are similar to members of other ethnic groups, such as cost, transportation, fear, and repulsion toward the screening process.