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.

Breast Cancer

 “African American, Native American, and Hispanic white women face a 10% to 70% greater risk of dying after a breast cancer diagnosis as compared to non-Hispanic whites (48)”

 
Breast cancer is the number one cancer site in the Cherokee Nation Tribal Jurisdictional Service Area (CNTJSA) population among the Native American women living in this area. This type of cancer is most always caught at later stages in this population group. Very few cases are diagnosed at the local stages and none have been diagnosed at the earliest stage.
 
Although these women may come in for screening and diagnosis, there is often a big time lapse before any treatment is obtained. This is partly due to many women being caregivers themselves and they usually take care of their family before they take care of themselves. Many are below average income and do not have insurance or other sources for payment, or they may have other medical conditions that need to be taken care of before cancer treatment can begin. This could also be a factor in what type of treatment may be administered. Language and cultural barriers may be involved, as well as sacred beliefs and myths. Other barriers involve treatment options that are not available in the CNTJSA; the patient will have to find transportation; gas money and child care before getting these treatments. Many reasons may exist for this time lapse, and efforts to reduce the time between diagnosis and treatment must be made.
 
Breast Cancer in the United States
Breast cancer is the most frequently occurring cancer among females, and is the second leading cause of mortality for women in the United States.   It is estimated that in the United States there will be more than 215,000 new cases of breast cancer in 2004 (39). The lifetime probability of a woman having breast cancer is 1 in 6, and the probability of developing invasive disease is approximately 1 in 9 (39, 40). Moreover, it is estimated that 1 in 30 will die of the disease (40).
 
The overall mortality rate from breast cancer remained relatively unchanged prior to 1989, but since then mortality has declined steadily at a rate of approximately 2% per year (40). Much of this decline has occurred in white women younger than 55 years of age, and some ethnic groups such as African American women have had less than a 2% decline in annual mortality rate (39). 
 
Breast Cancer in Oklahoma
The following information is surveillance data obtained from the Oklahoma Central Cancer registry (OCRA), a statewide population-based cancer surveillance system for the state of Oklahoma. Other information was obtained from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing, state-based telephone surveillance system. 
 
According to the information obtained from the OCRA, breast cancer cases that are diagnosed at the early stages have a 97% chance of living for at least five years, but 27.3% of female breast cancers diagnosed in Oklahoma are diagnosed at a regional or distant stage.