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Almost everyone has had contact with cancer.

People either have had cancer themselves, or know of a family member or friend who has had cancer.
That’s why getting a better understanding of it can help prevent or treat it.

“Disparities in Cancer within Ho-Chunk Contract Health Service Delivery Area 2003-2012,” a study of cancer and how it affects the Ho-Chunk population has recently been released. The study was conducted by the Carbone Cancer Center at the University of Wisconsin School of Medicine and Public Health.

The study shows that the incident and mortality rates for lung cancer are lower in the Ho-Chunk region than other Native American regions, but much higher in colorectal cancer incidences and mortality. Also, prostate cancer among men is more prevalent, as well as breast cancer among women.

In this study, Native Americans are referred to as American Indians.

The Spirit of Eagles and the Cancer Health Disparities Initiative, which are programs of the Carbone Cancer Center, has a history of working with tribes concerning cancer trends and rates among American Indians in Wisconsin, according to Rick Strickland, program director at UW’s Cancer Health Disparities Initiative (CHDI).

“We made a presentation to the Tribal Health Directors Association at one of their meetings, Strickland said. “We presented a summary of what were the rates for the latest period of time for the state as a whole. Then we showed them what were the rates for American Indians in CHSDA (Contract Health Service Delivery Area) counties of the state.

“When we presented, through discussion it was asked if there was a way to provide each tribe with its own data,” Strickland said. “I explained that the only way we would be able to do something, where we would be able to access any type of information through the state, would be if we looked at the CHSDA regions for each tribe. The consensus of the people attending was that we should do that. The idea would be that we would do that, but send the data only to the tribal health director of that individual tribe.”

Department of Health Director Ona Garvin received Ho-Chunk data of this report and all the other directors received the data for their tribes. There was no comparison done between the individual tribes to honor the fact that each tribe is the owner of their own data, he said.

The report offers rates for new cancer cases and deaths to cancer for the Ho-Chunk CHSDA counties. In Wisconsin, there are 32 CHSDA counties, of the 72 counties in the state, including Adams, Clark, Columbia, Crawford, Dane, Eau Claire, Jackson, Juneau, La Crosse, Marathon, Monroe, Sauk, Shawano, Vernon, and Wood counties.

“American Indians in the state of Wisconsin have both overall a higher incidence and a higher mortality, or a higher number of new cases and a higher number of deaths due to cancer,” Strickland said.
In the report, incidence and mortality bar graphs display rates for American Indians and Alaska Natives living in all CHSDA counties across the state.

The data was converted into rates because the number of people was such a small amount. The smaller the population, the less stable the rate, meaning it can be easily influenced by a few cases, Strickland said.
According to the data collected, American Indians and Alaskan Natives have a 6 percent higher rate than white men and women in the same geographical area, however, are 17 percent lower than other American Indians and Alaskan Natives across the state.

The Ho-Chunk mortality rates for men and women combined and for women alone are lower than for the associated rates for AI/AN across the state.

All Ho-Chunk sites mortality rate is 43 percent higher than the rate of white men and women living in the same counties.

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Ho-Chunk men have a cancer rate that is 70 percent higher than for white men living in the same counties and six percent higher than for other American Indians and Alaskan Natives across the state.

“The best thing about the cancer report is that it is current data on common types of cancer in Ho-Chunk people living in our CHSDA,” said Amy DeLong, MD, MPH, medical director of the HCN Department of Health and family physician.

“The data tells us that our smoking cessation efforts are paying off, based on the evidence of lower lung cancer incidence and mortality. The data also tell us that we have more work to do with colon cancer screening. Ho-Chunk men in particular need to do the FIT test, stool sample card that is done in privacy of own home, or the colonoscopy, which is a procedure done with a general surgeon or GI specialist under anesthesia. Colon cancer screening is done for everyone age 50 years or older, or lower age in those with a family history of colorectal cancer.”

For prevention of any cancer, or any chronic disease, people need to eat more vegetables, walk more, and quit smoking or not to start smoking, DeLong said.

Lifestyle choices, rather than heredity, have a bigger influence on the chances of the development of cancer, Strickland said.

“There are a few cancers that have a tendency to run in families because they may involve a mutation of a particular gene. This is a few cancers, but not the majority,” he said.

“There are more than 200 types of cancers that we know of. What is important to realize that there are some forms of cancers that there is a tendency to run in families, that’s often due to an abnormality of a particular gene that’s inherited in that family. But that is much less common than other kinds of things that both fall into the realm of behavior, and choices that people make in terms of their lifestyle, and also exposures they have to both environmental toxins and/or sources of stress and trauma in their lives,” Stickland said.

For example, inappropriate use of tobacco, abuse of tobacco, for any population, increases the risk of cancer, and not just lung cancer, but also it increases the risk for many cancers, he said. Diet that is low in vegetables and fruits and high in carbohydrates and fatty meats coupled with a lack of activity can also be a significant source to help increase the risk.

“There’s no one thing that causes cancer, but what is important to understand is increasing one’s risk or reducing one’s risk. There are certain lifestyles that you can choose,” he said. “What’s important is to get regular screenings that is appropriate for the person’s age and gender.”

Written by Ken Luchterhand

Ken Luchterhand is a reporter for Hocak Worak, the newspaper of the Ho Chunk Nation.

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