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Cancer Facts and Figures from the ACS, and the Can- cer Planet website. Consideration should be given to providing regional data for the AI/AN population when state-based data are provided for other popula- tions. Key to long-range improvement in cancer inci- dence, morbidity, and mortality is building the infrastructure to support comprehensive cancer con- trol at the community level. The data in this report will strengthen those efforts.

In conclusion, considerable progress has occurred in cancer surveillance in AI/AN populations to pro- vide a more comprehensive and accurate picture of the cancer burden in this population than was avail- able previously. This report describes disparities in cancer incidence and gaps in cancer risk factors and screening that provide a clear, albeit challenging, course of action for national and local cancer control partners. Sufficient diagnostic and treatment capacity must be made available as screening services expand to accommodate those persons with positive screen- ing examinations or those who are diagnosed with cancer. The substantial strides made in cervical can- cer control for AI/AN women over the last 20 years by expanding screening and diagnostic follow-up ser- vices should serve as a model for addressing other cancers and risk factors. Future progress in decreas- ing the cancer burden in AI/AN populations is neces- sary and achievable with implementation of comprehensive cancer control programs that provide direction and motivate and actively engage partners across the spectrum of cancer control advocates, healthcare providers, policymakers, tribal leaders, and funding agencies.

In summary, the collaboration among the major public health cancer surveillance organizations in the U.S. (including, for the first time this year, the IHS) to produce the annual report to the nation on the status of cancer enables a comprehensive review and analysis of the progress being made in diminish- ing the cancer burden, highlighting the challenges ahead, and focusing on timely issues such as health disparities, cancer care, and specific segments of the cancer continuum, from screening and risk behaviors in healthy persons to quality of life for patients who are dying from cancer. This year’s report provides the most comprehensive description of cancer incidence in the AI/AN population available to date and highlights several areas of progress in the general population, notably the continued decline in cancer mortality rates and the recent decline in female breast cancer incidence rates after 20 years of in- creases. The commitment and leadership from the national organizations to the state cancer registries, vital statistics systems, and local hospitals and other

Report to the Nation, 19752004/Espey et al.


medical facilities that support the infrastructure are critical components that provide information for cancer control, public policy, and identifying impor- tant avenues for future research.


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