With the onset of October each year, the biggest conversations in Indian country generally focus on Columbus Day and Halloween. But breast cancer has gained attention recently. The national annual campaign began in 1985 as a partnership between the American Cancer Society and AstraZeneca, a pharmaceutical corporation and developer of several cancer drugs, “to promote breast cancer awareness, share information on the disease and provide greater access to services.” Additionally, the third week of October has become “Male Breast Cancer Awareness Week” since 2009 when several advocacy groups partnered to raise awareness.
Gender, Incidence, and Mortality Rates
In a Breast Cancer Awareness Presidential Proclamation, President Barack Obama notes: “Breast cancer, one of the most common cancers among American women, affects roughly 230,000 women as well as 2,300 men each year and is responsible for more than 40,000 deaths annually in the United States.” In 2013, the Centers for Disease Control (CDC) reported that cancer is the biggest killer of American Indians and Alaskan Natives regardless of gender in the U.S. behind heart disease. American Indians and Alaska Natives face unique health disparities. “American Indians face alarming inequities in cancer incidence and mortality. Cancer incidence rates vary by tribe, region and gender but are often much higher than non-Hispanic Whites,” reports the American Indian Cancer Foundation.
Breast cancer is the second most common cancer for all women in the U.S, according to the CDC. Native women are among the least likely to develop breast cancer, says the CDC, yet are likely to have the disease go undetected. Though the incidences of and death from breast cancer may be higher than existing data suggests because cases for Indian country are under-reported: “Data on cancer in Native Americans is limited because not all Native American communities are part of cancer registries, and Native Americans are not always identified as such on health forms. Also, Native Americans have a low participation rate in any type of cancer clinical trials or research,” the Breast Cancer Resource Directory of North Carolina states. “Cancer among Native Americans is becoming a growing concern. Within the last few generations, cancer has become the leading cause of death for Alaska Native women and is the second leading cause of death among American Indian women.”
While specifics on breast cancer in Native men are harder to come by than Native women, men generally account for roughly one percent of breast cancer cases, with the disease often being fatal, according to the Maurer Foundation. The His Breast Cancer advocacy organization for men reports: “Even if the percentage of men diagnosed with male breast cancer is small, it is often more fatal for a large percentage of the men diagnosed. Since most men don’t know to look for it, the disease is usually found after it has progressed to a more dangerous level.”
There is no data available on the incidence rates for other genders. Research and related data collection is still focused on the female-male binary, so calculating specific risk of breast cancer for Two-Spirit individuals and other genders is not currently possible. According to the Dr. Susan Love Research Foundation For a Future Without Breast Cancer, “The bottom-line up front: We don’t know. That’s because we have no data on the incidence of breast cancer in transsexual or transgender individuals. There are, however, some things we have learned about risk from non-trans women that could impact breast cancer risk in trans individuals.”
Aging: the risk for breast cancer increases for women 40-59;
Menstruation before age 12 and menopause after age 55;
Prolonged hormone replacement therapy treatment;
Poor diet, high alcohol consumption, smoking and chewing tobacco combined with a sedentary lifestyle;
Existing health conditions like diabetes and/or obesity;
Breast Health and Preventative Healthcare
Be aware of the warning signs;
Do self exams;
Get regular mammograms.
Indian Country Initiatives
American Indian Cancer Foundation Healthy Native Foods Learning Tour
The commonality for everyone regardless of gender, socio-economic status, and geographic location is preventative healthcare. An ongoing study recently released evidence that the most common form of breast cancer no longer requires intensive chemotherapy if caught early enough. The CDC provides free and low-cost mammograms through its National Breast and Cervical Cancer Early Detection Program. To qualify individuals must be between the ages of 40 and 64, and on low income or without insurance. Call (800) CDC-INFO.
Follow ICTMN Correspondent Lisa Ellwood on Twitter at www.twitter.com/IconicImagery