Report Shows Wide Regional Disparities Seen in Alaska’s Lung and Colorectal Cancer Rates

An inflatable model of a colon is displayed October 20 at the 2022 Alaska Federation of Natives convention in Anchorage. (Photo by Yereth Rosen/Alaska Beacon)

Alaska (Alaska Beacon): Colorectal cancer rates in certain parts of rural Alaska are up to 2.5 times higher than the state average, and patients in those rural areas appear to be diagnosed so late that cancers are far advanced sooner of being diagnosed. identified, according to a new report issued by the state Department of Health.

The report, issued this week by the department’s Alaska Cancer Registry, tracks rates of various cancers and their occurrences in different regions of the state from 2015 through 2019, the most recent years for which data is available. It updates a similar report published in 2020.

The report presents a focus on late-stage cases, for which earlier interventions may have lessened impacts.

The results point to the need for more early detection in those rural areas, according to the report: “Effective screening programs should result in the early detection of more cancers, so late-stage cancer rates should decrease.”

The results also point to the need for more work to reduce the medical risks associated with colorectal and other cancers, primarily smoking and obesity, according to the report. “Comprehensive control and prevention programs that focus on reducing behavioral risk should result in fewer cancers, so overall cancer incidence should decrease.”

For colorectal cancer, the rates were highest in the Yukon-Kuskokwim Delta region, the report shows. The region has an estimated case rate of 102.4 per 100,000 people over the five-year study period, compared with the statewide average of 41.3 per 100,000, according to the report. Rates during the period were also high in northwestern and interior Alaska, estimated at 79.5 and 56.8 per 100,000, respectively, according to the report.

For patients with late-stage cases, the Yukon-Kuskokwim rate was also about 2.5 times higher than the state rate. Among people ages 45 to 75, Yukon-Kuskokwim’s late-stage colorectal cancer rate was estimated to be 124.9 per 100,000 people over five years, compared to a statewide rate of 49.7 for that group old.

Alaska Natives have the highest documented rates of colorectal cancer in the world, and the Yukon-Kuskokwim region has long been a hotspot for the disease. The exact reasons aren’t clear, but a diet high in fat and low in fiber may be a factor, health experts said.

Although colorectal cancer generally affects older adults, more and more younger native adults have been diagnosed in recent years. Ten years ago, the Alaska Native Medical Center and the Alaska Native Tribal Health Consortium changed their colorectal cancer screening guidelines, which now recommend that patient screening begin at age 40. Current national guidelines recommend that screenings for the US general population begin at age 45, a change from the widely used 50-year threshold before 2021.

Efforts are already underway to boost colorectal cancer screening among Alaska Natives, especially in the hard-hit Yukon-Kuskokwim region.

In addition, the report finds much higher rates of lung and bronchial cancer, both overall and in advanced stages, in Northwest Alaska. Case rates in that region were estimated at 93.4 per 100,000 people, compared with the state rate of 54.1 per 100,000 people. The disparity is greatest for cases of late-stage bronchial and lung cancer. Among residents ages 50 to 80, late-stage cancer in that category occurred at a rate of 232.8 per 100,000 people, double the statewide rate for that age group, according to the report.