Mayo, IHS join to curb cancer

Greater access to care is focus

By Terry Woster
New York Times

A cooperative effort between the venerable Mayo Clinic and Indian Health Service has the potential to improve health care in Indian Country, if money and equipment go to isolated areas, an Eagle Butte cancer-screening specialist says.

Mayo and IHS issued a written statement Monday saying they had a memorandum of understanding for a "collaborative relationship" that would use the combined strengths of the two entities "to reduce cancer and related health burdens in American Indian and Alaska Native communities."

Details of the agreement are being worked out, an IHS public information staffer said Monday. Those details will tell whether the cooperative effort will make a difference in Indian Country, says Deleen Lamb of Eagle Butte.

One focus of the collaboration will be to provide Indian people with greater access to health care and preventive medicine. That's vital in Indian Country, says Lamb, director of the breast and cervical cancer early-detection program on the Cheyenne River Reservation.

"Early screening is important but too seldom available in many (reservation) areas," Lamb said. "If they will bring the resources to the isolated areas where people need those services, it has potential."

Lamb said mammograms and colonoscopies - vital in early detection of breast and colon cancers - aren't routinely available in parts of Indian Country. Residents with little money and a long drive to a fully equipped medical center often put off preventive medical procedures and seek care only when conditions become serious, she said.

The cooperative agreement, the two groups said, "recognizes that the IHS and Mayo have different resources, functions, roles and areas of expertise." The entities will work jointly in these five areas:

  Education and training, to encourage Native American students working toward careers in health care.

  Career opportunities for qualified Indian researchers, clinicians and other health care workers.

  Research focused on Indian health issues.

  Funding to identify the proper federal or foundation grant programs to support the research and services.

  Cost-effective health care and preventive services, aimed at developing greater access to quality health care and preventive medicine that meets the identified needs of the target groups.

Specific steps have yet to be made public, but Dr. Denis Cortese, Mayo Clinic president, said research and bolstering access to care on remote reservations would be key.

The Mayo Clinic, based in Rochester, Minn., has a history of working with Native American and Alaska Native students and health-care professionals "in a way that respects tribal sovereignty and self-determination," Dr. Charles Grim, IHS director, said in a prepared statement. "In treating American Indian and Alaska Native people, Mayo and the IHS have worked to integrate traditional medical practices into their care when this has been requested."

A cancer control plan put together a year ago in South Dakota said Native Americans, geographically isolated and poor populations "are carrying a greater portion of the cancer burden than they should be."

When that plan was released, Lamb said she thought Lakota women in the state had about the same cancer rates as other women, "but they have a higher prevalence of late detection. That's because of the lack of access."

A review of tumor registry information from 1990 through 2000 at Rapid City Regional Hospital showed that half of the Native Americans with cancer had late-stage forms of the disease, compared with about one-third of the general population seen at the hospital. Later stages of the disease usually are more difficult to treat, and the long-term outcomes generally aren't as positive.