title: Tribal-based cancer control activities. Services and perceptions.
abstract: BACKGROUND
  Cancer is becoming a significant health problem for American Indians and Alaska Natives. Despite the precipitous increase in cancer rates in these populations, limited data are available regarding the extent of cancer control services available in these communities.
  
  
  METHODS
  A cross-sectional survey of tribal health directors of all federally recognized tribes was undertaken to discover the breadth of cancer control activities offered and directors' perceptions of and priorities ascribed to cancer.
  
  
  RESULTS
  Little more than half (53%) of respondents perceived cancer rates to be increasing. Cancer was found to rank fifth among seven health conditions when directors were asked to rank their tribe's commitment to confronting each. Lower relative levels of awareness of cancer patterns coupled with competing health problems relegated cancer control activities to low-priority issues.
  
  
  CONCLUSIONS
  Findings from this study underscore the need to elevate the issue of cancer in Indian Country and to educate investigators to become more sensitive and responsive to other tribal health issues.
authors.affiliation: Department of Educational Affairs, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Michalek
authors.forename: M C
authors.initials: MC
authors.lastname: Mahoney
authors.forename: D
authors.initials: D
authors.lastname: Tome
authors.forename: M
authors.initials: M
authors.lastname: Tenney
authors.forename: L
authors.initials: L
authors.lastname: Burhansstipanov
mesh_terms: D000413:Alaska / Q000453:epidemiology; D019538:Health Care Surveys; D006292:Health Priorities; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D004930:Inuit / Q000706:statistics & numerical data; D009369:Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service