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

 Some risk factors for breast cancer can be controlled while others are inherited or are otherwise unchangeable, as with age; the primary risk factor. Therefore, all women are at risk for breast cancer and the risk increases with the following factors which can be categorized into factor (i) factors which influence the hormonal or reproductive status of the patient, (ii) dietary and environmental factors, (iii) demographic factors, (iv) benign breast conditions, and (v) genetic and hereditary factors:

 
Hormonal or Reproductive Factor
Gender – women are at a higher risk of getting breast cancer then men
Birth of a child – being an older age at first birth or never having given birth to a child
Menstrual periods – having had early menstrual periods, before the age of 12, and women who have gone through menopause after the age of 50
Not breastfeeding (breast feeding has a protective effect)
Use of hormone replacement therapy, such as estrogen and progesterone
Obesity (likely due to increased levels of circulating estrogens)
 
Dietary and Environmental Factors
·         High fat diet, moderate alcohol intake
·         Exposure to ionizing radiation
 
Demographic Factors
·         Age – as age increases, risk also increases, beginning at age 45 and increasing over the remainder of the lifetime.
·         Personal history – having breast cancer in the past increases the chances of getting cancer in the other breast, or getting cancer in the same breast in another location
·         Race – white women appear to have a slightly greater risk of getting breast cancer, but mortality rates among African Americans is higher
·         Higher socioeconomic status - increases risk of breast cancer
 
Benign Breast Conditions
·         Density in breast tissue – breast tissue that shows density in a mammogram
·         Proliferative lesions such as lobular or ductal atypia, papillomas, or fibroadenomas
 
Genetic and Hereditary Factors
·         Family history – having a blood relative diagnosed with breast cancer at a young age, which doubles if the blood relative is a mother, sister, or daughter
·         Genetic risk factors – mutations in genes, the most common being BRCA1 and BRCA2