The 2019 Healthy Alaskans State Health Assessment reports that cancer is the leading cause of death in Alaska and the second leading cause of death in the United States (2017 data). The Alaska cancer mortality rate for all Alaskans in 2018 was148.8 per 100,000 population, while the U.S. cancer mortality rate is 158.3 per 100,000. There are also noted health disparities in cancer mortality rates, with Alaska Native people having the highest rates of colorectal cancer in the country. The most recent Healthy Alaskans 2020 scorecards show that in 2018, the cancer mortality rate for all Alaskans was 148.8 per 100,000 but for Alaska Native people it was 199.2 per 100,000.

Based on the aforementioned data and the State Health Assessment survey responses from a diverse range of Alaskans cancer was identified as a key priority for Healthy Alaskans going forward, the Healthy Alaskans teams decided that reducing the cancer mortality rate should be kept as a health objective during the ten year time period of the State Health Improvement Plan. Since Alaska was successful in reaching targets set for cancer mortality among all Alaskans as a whole in the Healthy Alaskans 2020 (HA2020) plan, but not for Alaska Native people, it is important to keep this health objective in the plan and refocus efforts to address health equity considerations and prevention efforts across the state as related to cancer. The HA2030 teams also focused on creating strategies to support increasing prevention, screening, and treatment options available help decrease death rates due to cancer.

The U.S. Preventive Services Task Force is an independent panel of experts in primary care and prevention who systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services. These reviews are published as U.S. Preventive Services Task Force A and B recommendations. As of 2019, the USPSTF cancer screening recommendations include breast, cervical, colorectal, and lung.

Sources:
https://www.uspreventiveservicestaskforce.org/, https://www.thecommunityguide.org/

Patient navigators, sometimes called systems navigators, provide culturally sensitive assistance and care coordination, determining individual barriers and guiding patients through available medical, insurance, and social support systems.  According to the County Health Rankings, there is strong scientific support that having patient navigators increases cancer screening.  Other potential benefits include improved cancer care and access to care.

Sources:

• https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/patient-navigators
• https://www.uspreventiveservicestaskforce.org/, https://www.thecommunityguide.org/

Cancer reoccurrence rates for cancer survivors can be as low as 9% (child leukemia depending on risk) and as high as nearly 100% (Glioblastoma cancers).  For Breast cancer survivors, recurrence is 30% overall. Studies show that cancer survivors do not receive the appropriate oncology and primary care services.  Monitoring recurrence and remission, addressing the late effects of cancer treatment, managing co-morbidities, and conducting routine screenings requires that cancer survivors have adequate routine medical care.

Sources:

• https://www.aafp.org/afp/2015/0101/p29.html
• https://www.cancertherapyadvisor.com/home/tools/fact-sheets/cancer-recurrence-statistics/,
• https://www.uptodate.com/contents/overview-of-cancer-survivorship-care-for-primary-care-and-oncology-providers
• https://www.cdc.gov/cancer/survivors/life-after-cancer/survivorship-care-plans.htm