Hidden in the Data: Breast Cancer Patterns, Gaps, and Challenges for Native American Women.

Area of Science:

• Public Health
• Oncology
• Health Disparities

Background:

• Breast cancer presents complex public health challenges for American Indian/Alaska Native (AI/AN) women, characterized by regional variations in incidence, stage, treatment, and survival rates.
• Limited access to screening mammography, healthcare workforce shortages, and underfunded systems contribute to delayed diagnoses and poorer prognoses.
• Social determinants, historical trauma, and medical mistrust exacerbate care barriers, compounded by data limitations and underrepresentation.

Purpose of the Study:

• To provide a comprehensive overview of breast cancer screening, clinical characteristics, treatment, and survivorship among American Indian/Alaska Native (AI/AN) women.
• To highlight the disparities and contributing factors affecting breast cancer outcomes in this population.
• To propose a framework for future research and interventions centered on Indigenous priorities.

Main Methods:

• A comprehensive literature review was conducted by Indigenous surgeons with expertise in AI/AN communities.
• The review synthesized existing data on breast cancer incidence, diagnosis, treatment, and survivorship in AI/AN women.
• Perspectives from Indigenous health experts were integrated to inform the analysis and recommendations.

Main Results:

• Breast cancer outcomes for AI/AN women are marked by significant regional disparities.
• Late-stage diagnoses are common due to limited screening and healthcare access.
• The Indian Health Service (IHS) faces challenges in meeting the complex needs of AI/AN women, particularly in urban settings.

Conclusions:

• Reducing breast cancer disparities requires prioritizing Indigenous leadership and respecting tribal sovereignty.
• Improving data accuracy and fostering equitable collaborations are essential for advancing AI/AN women's health.
• Centering AI/AN community priorities in research and healthcare delivery is crucial for achieving equitable outcomes.