title: Cancer Screening on the Hopi Reservation: A Model for Success in a Native American Community.
abstract: American Indian women have lower cancer survival rates compared to non-Hispanic White women. Increased cancer screening fostered by culturally sensitive education and community programs may help decrease this disparity. This study assesses the effectiveness of Hopi Cancer Support Services (HCSS) in maintaining high rates of breast and cervical cancer screening among Hopi women and evaluates the impact of participation in HCSS programs on colorectal cancer (CRC) screening. A population-based survey was conducted on the Hopi reservation in 2012 (n = 252 women). Frequency of breast, cervical, and colorectal cancer screenings, participation in HCSS programs and barriers to screening were evaluated. Unconditional multiple logistic regression estimated the independent effect of the HCSS program on CRC screening. Approximately 88 % of Hopi women 40+ reported ever having had a mammogram; 71 % did so within the past 2 years. Approximately 66 % of women 50+ were ever screened for colorectal cancer (FOBT and/or colonoscopy). Women who had their last mammogram through HCSS were 2.81 (95 % CI 1.12, 7.07) times more likely to have been screened for CRC. Breast and cervical cancer screening continues at a high rate among Hopi women and is substantially greater than that reported prior to the inception of HCSS. Furthermore, participation in programs offered by HCSS is strongly associated with increased colorectal cancer screening. This tribal health program (HCSS) has strongly influenced cancer screening among Hopi women and is a model of a tribally run cancer prevention program.
authors.affiliation: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin, Tucson, AZ, 85724-5163, USA. srbrown@email.arizona.edu.|Arizona Cancer Center, University of Arizona, Tucson, AZ, USA. srbrown@email.arizona.edu.
authors.forename: Sylvia R
authors.initials: SR
authors.lastname: Brown
authors.affiliation: Hopi Department of Health and Human Services, The Hopi Tribe, Kykotsmovi, AZ, USA.
authors.forename: Lori
authors.initials: L
authors.lastname: Joshweseoma
authors.affiliation: Arizona Cancer Center, University of Arizona, Tucson, AZ, USA.
authors.forename: Kathylynn
authors.initials: K
authors.lastname: Saboda
authors.affiliation: Department of Health Sciences, College of Health and Human Services and Department of Applied Indigenous Studies, College of Social and Behavioral Sciences, Northern Arizona University, Flagstaff, AZ, USA.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Sanderson
authors.affiliation: Hopi Cancer Support Services, The Hopi Tribe, Kykotsmovi, AZ, USA.
authors.forename: Delores
authors.initials: D
authors.lastname: Ami
authors.affiliation: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin, Tucson, AZ, 85724-5163, USA.|Arizona Cancer Center, University of Arizona, Tucson, AZ, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001130:Arizona; D001943:Breast Neoplasms / Q000175:diagnosis; D015179:Colorectal Neoplasms / Q000175:diagnosis; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D007198:Indians, North American; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000208:ethnology*; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis; D055815:Young Adult
keywords: Cancer; Cancer screening; Community health; Reservation; Rural; Screening; Tribal health