Comprehensive Cancer Control Plan

The Cherokee Nation Comprehensive Cancer Control (CNCCC) Project assists in the development of networks and collaboration that produce an infrastructure for a comprehensive approach to cancer within the Cherokee Nation. Since 2003, coalition members and partners have come together to discuss the burden of cancer in Cherokee Nation. Coalition members and partners include local, regional, state and national representatives committed to identifying areas of cancer concern, planning interventions, prioritizing greatest areas of identified need, and then implementing identified strategies and/or providing needed resources. This is the second edition of the Cherokee Nation Comprehensive Cancer Control Plan and will serve, like the first, as an information resource for health care professionals and community members, as well as a tool for the Cherokee Nation Comprehensive Cancer Control Coalition and its respective entities. The coalition is committed to the process of enhancing infrastructure for comprehensive cancer control in the Cherokee Nation with the ultimate goal of reducing morbidity and mortality among the Cherokee community.

Risk Factors

Risk Factors
Among the diverse group of cancers included in this chapter, the following cancer sites have clearly identified modifiable risk factors:
·         Oropharyngeal tumors
-         Smoking and use of smokeless tobacco
-         Drinking alcohol
-         Epstein-Barr Virus (nasopharyngeal carcinoma)
·         Digestive Organs
-         Hepatitis C (hepatocellular carcinoma, biliary tumors)
-         Drinking Alcohol (hepatocellular carcinoma, biliary tumors, esophageal cancer)
-         Smoking (pancreatic, esophageal, and stomach cancers)
-         Helicobacter pylori infection (stomach cancer)
·         Respiratory System and Intrathoracic Organs
-         Smoking (mesothelioma)
-         Asbestos exposure (mesothelioma)
·         Hematopoietic, Reticuloendothelial, and Lymphoma
-         Chemotherapy, radiation exposure
-         Benzene exposure
-         HIV, HTLV, Epstein-Barr Virus infection
·         Bladder Cancer
-         Smoking
·         Skin Cancers
-         Artificial tanning and sun exposure
·         Ovarian Cancer
-         Use of unopposed estrogen
-         Obesity
For each of the malignancies listed above, primary prevention involves minimizing the associated environmental or infectious risk factors. Among these risk factors, some of the strongest associations are smokeless tobacco/oropharyngeal carcinoma, smoking tobacco/mesothelioma, and skin malignancies/sun exposure. Particular emphasis should be directed towards education campaigns to reduce these risk factors in the Cherokee Nation.