Rates of colorectal cancer in certain parts of rural Alaska are up to 2.5 times as high as the state average, and patients in those rural areas appear to be getting diagnosed so late that the cancers are well advanced before they are 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 types of cancers and their occurrences in different regions of the state from 2015 to 2019, the most recent years for which data is available. It updates a similar report released in 2020.
The report features a focus on late-stage cases, for which earlier interventions may have lessened the impacts.
The results point to a need for more early screening in those rural areas, the report said: “Effective screening programs should result in more cancers being found early, thus late-stage cancer rates should decrease.”
The results also point to a need for more work to reduce medical risks linked to colorectal and other types of cancer, largely smoking and obesity, the report said. “Effective comprehensive control and prevention programs focusing on reducing behavioral risk should result in fewer cancers, thus overall cancer incidence should decrease.”
For colorectal cancer, rates were highest in the Yukon-Kuskokwim Delta region, the report shows. The region has a case rate calculated at 102.4 per 100,000 people over the five-year study period, compared to the state average of 41.3 per 100,000, the report said. Rates over the period were high in Northwestern and Interior Alaska as well, calculated at 79.5 and 56.8 per 100,000 respectively, the report said.
For patients with late-stage cases, the Yukon-Kuskokwim rate was also about 2.5 times as high as the state rate. Among people 45 to 75 years old, the Yukon-Kuskokwim late-stage colorectal cancer rate was calculated at 124.9 per 100,000 people for the five years, compared to a statewide rate of 49.7 for that age group.
Alaska Natives have the world’s highest documented colorectal cancer rates, and the Yukon-Kuskokwim region has long been a hotspot for the disease. Exact reasons are unclear, but a high-fat, low-fiber diet may be a factor, health experts have said.
Although colorectal cancer usually strikes older adults, younger Native adults have been increasingly diagnosed in recent years. Ten years ago, the Alaska Native Medical Center and Alaska Native Tribal Health Consortium shifted their colorectal cancer screening guidelines, which now recommend that patient screenings start at age 40. Current national guidelines recommend screenings for the general U.S. population to start at age 45, a shift from the 50-year-old threshold widely used prior to 2021.
There are already efforts underway to boost screenings for colorectal cancer among Alaska Natives, especially in the hard-hit Yukon-Kuskokwim region.
Additionally, the report finds much higher rates of lung and bronchial cancer – both overall and late-stage occurrences – in Northwestern Alaska. Case rates in that region were calculated at 93.4 per 100,000 people, compared to the statewide rate of 54.1 per 100,000 people. The disparity is higher for late-stage cases of lung and bronchial cancer. Among residents 50 to 80 years old, late-stage cancer of that category occurred at a rate of 232.8 per 100,000 people, twice the statewide rate for that age group, the report said.
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