Colorectal Cancer in the American Indian and Alaska Native Community: A Holistic Review

Despite a decline in colorectal cancer (CRC) incidence and mortality for the general United States population, American Indian/Alaska Native (AI/AN) populations have seen an increase in both measures. AI/AN populations have also experienced the largest increase in early-onset colorectal cancer, have the second highest CRC incidence rates, and the AN community has the highest rates of CRC worldwide. AI/AN populations face numerous barriers, including limited access to care and a shift in dietary preferences away from traditional foods, which may contribute to these findings. This review of the literature explored what types of CRC research have been conducted and found that 7.1% is on diet, 8.2% on age, 3.5% on geography, and 64.7% on screening. This review expands the focus beyond screening and highlights research focused on potential underlying causes of CRC in AI/AN communities. A more comprehensive and population-specific fund of knowledge on the totality of the subject is critical to directing more effective prevention, earlier detection, and management. Evaluating different components of CRC honors the holistic approach to health practiced by many AI/AN communities.