Abstract A51: Selected physical findings from Native American Cancer Education for Survivors (NACES)

Introduction: Native Americans continue to have the poorest five-year relative survival from cancer in comparison to all other racial groups in the US. “Native American Cancer Education for Survivors” (NACES) is a web-based public health education program presented in modules and designed to provide and assess the effectiveness of a culturally appropriate intervention on quality of life of Native American breast cancer survivors. The purpose of NACES is to improve the QOL of cancer patients by increasing knowledge and informed choice using innovative, tailored web-based technology.

Methods: NACES is a community driven research and education project, based on the Social Cognitive Theoretical Model. Participants complete a QOL survey that includes physical, psychosocial, spiritual and social components. This session focuses on the physical component of the survey collected by trained Native Patient Advocates and compares physical conditions among Native breast survivors who were diagnosed within one year, between one to four years previously, and those who were diagnosed five or more years ago.

This is the first time that survivorship issues are reported specifically for Native breast cancer patients. Of the patients who completed NACES surveys with Native Patient Advocates by September 2008, 162 were breast cancer survivors. Almost all (98.1%; n=159/162) were female and more than half (n=93) diagnosed five or more years ago. Slightly more than half (54.7%; n=81/148) were full-bloods, 12.2% (n=18/148) were three-quarter blood quantum, 17.6% (n=26/148) were half-blood quantum and the rest were one-quarter or less blood quantum (n=23/148). More than half work for a salary or pay (54.7%; n=82/150) and of those who work, most work full-time (80.9%; n=72/89).

Selected access issues document situations that contribute to disparities. When asked if they were having or had difficulty getting cancer treatments, almost half (49.7%; n=73/147) responded “yes”. Co-morbidities such as high blood pressure and arthritis are common in the survivors, with a third having diabetes, in addition to breast cancer. Numerous side effects from cancer treatments are experienced by these survivors.

Conclusions: Continued needs exist for culturally relevant education to address the health problems and challenges that patients face to obtain quality care. Although the percentage of Native breast cancer survivors who were within one year of their diagnosis self-reported many physical problems, for those diagnosed five or more years ago, the percentage of physical conditions was significantly less. Thus, there is a message of hope for the newly diagnosed patients who frequently feel their health may remain as it was within that initial year of the diagnosis.