Study: Alaska Native people more susceptible to colorectal cancer

ANCHORAGE, Alaska (KTUU) - Television and movie actor James Van Der Beek, who died Wednesday at age 48, previously revealed he was diagnosed with stage 3 colorectal cancer. No official cause of death was given.

In Alaska, the threat of that kind of cancer is more grave than most the country.

Dr. Charles Portera, who is the lead and founder of surgical oncology at Providence Alaska Medical Center in Anchorage, says education is key to helping prevent colorectal cancer.

Portera says colorectal cancer is a catch-all phrase for colon and rectal cancer, and there’s been a rising trend of younger adults getting diagnosed with it.

Alaska Native populations are particularly susceptible to that risk, according to medical experts. An analysis highlighted by Mayo Clinic found that Alaska Native colorectal cancer rates has at times exceeded 60 cases per 100,000 people, a rate well above the U.S. average and higher than many global benchmarks.

Researchers tie the gap not to a single cause, but to a mix of access barriers, historic health inequities, and differences in screening accessibility.

Dr. John Kisiel, professor of medicine and a gastroenterologist at Mayo Clinic in Rochester, Minnesota, co-authored a study with Dr. Diana Redwood, a senior epidemiologist at the Alaska Native Tribal Health Consortium in Anchorage, that was published in the Journal of Rural Health looking at why Alaska Native people weren’t keeping up with recommended screening programs.

“In the United States, there will be about 40 per 100,000 people will get colon cancer each year,” Kisiel said. “Unfortunately for Alaska Native persons, that rate is twice as high.”

About five or six years ago, Redwood received a grant from the National Cancer Institute to study some different screening test interventions in the Alaska Native population,

The study did not simply catalog risk. It examined why many Alaska Native patients were not getting screened at recommended levels, even when screening was available. Investigators found that geography, transportation, cost of travel, and time away from work or family were all factors.

“There were a number of different barriers to getting screening,” Kisiel said.

Some early signs of colorectal cancer include bleeding in stools, which should be checked out by a doctor especially if there is family history of colorectal cancer.

“As that cancer continues to grow, then you can get larger tumors within the colon that will present with nausea and vomiting because of bowel obstruction, bloating, and weight loss,” Portera explained.

Portera did note that the Alaska Native population does have a higher risk of development of colorectal carcinoma, but that could be due to screening issues.

“Because of Alaska in general and some of the remote locations of villages in smaller cities that may not have access to colonoscopy,” Portera said. “But that’s where tests, some of the non-invasive tests such as the FIT test or the Cologuard test can come in handy.

“However, the limitations, access to the road system, and other issues socially can decrease that screening, the adherence to the screening recommendations.”

The research also pointed to the potential value of at-home, non-invasive tests such as FIT or Cologuard, especially for patients who cannot easily find a facility that performs colonoscopies.

Portera said the best time to intervene is when the cancer is at its earliest stages.

“I think it needs to be stressed that colorectal cancer can be prevented,” he said. “We can diagnose and intervene early, so it not only can it be prevented, but it can also be cured. If, however, these cancers go undiagnosed for a significant amount of time, then you get a more advanced malignancy with spread to, as you mentioned ... with the gentleman with the stage 3 disease, or it can spread further.”

Kisiel also stressed that colorectal cancer is uniquely preventable, if caught earlier.

“Our central message is to go out and be seen and get screened. Don’t try to rely on your family history, don’t try to rely on any symptoms,” he said. “There are many screening test options available. So, ask your doctor to have a conversation with you about that.”

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