Below is information on types of cancer and prevention.

Cervical Cancer Awareness

Cervical Cancer is a silent killer with signs and symptoms the can often be very subtle and misdiagnosed. To help a crop of future nurses better understand this terrible disease WW Hastings Indian Hospital Staff Physician and OBGYN Dr. David Gahn shared his knowledge with the students at the Indian Capital Technology Center in Tahlequah.

Summer Time and Tanning

A Base Tan Is Not a Safe Tan. There is a common misconception that a tan acts as the body’s natural protection against sunburn. The Burning Truth: A tan is the body’s response to injury from UV rays, showing that damage has been done. A “base tan” only provides a sun protection factor (SPF) of about 3 or less, which does little to protect you from future UV exposure.

Colon Cancer Prevention and Screening

Colon cancer rates drop sharply due to screenings

Colon cancer rates have dropped by 30% over the past decade for those over 50, and colonoscopies are getting much of the credit.

Doctors recommend that people at average risk begin getting screened for colon cancer at age 50.

Screening rates have climbed in recent years. The number of Americans ages 50 to 64 who have had a colonoscopy — which allow doctors to detect and remove polyps before they turn malignant — has nearly tripled, growing from 19% in 2000 to 55% in 2010. Use of colonoscopy also rose among those age 65 and over, growing from 55% in 2000 to 64% in 2010, according to the new report. To further reduce colon cancer cases and deaths, the American Cancer Society has set a goal of screening 80% of eligible people by 2018.

Colorectal cancer is the third leading cause of cancer death in the USA. The cancer society estimates that 136,830 Americans will be diagnosed with the disease this year and that 50,310 will die from it.

“We hope that we get the number much closer to zero by getting the at-risk population access to colorectal cancer screening,” says Arun Swaminath, a gastroenterologist and director of inflammatory bowel disease at New York’s Lenox Hill Hospital, who wasn’t involved in the new study.

Death rates from colon cancer also have fallen, declining at a rate of about 3% a year over the past decade, the report found. Colonoscopies can reduce mortality by allowing doctors to find tumors when they’re smaller and more curable.

“It’s really reassuring that we are making progress,” says Charles Fuchs, chief of gastrointestinal oncology at Boston’s Dana-Farber Cancer Institute, who wasn’t involved in the new study.

The biggest declines in colon cancer incidence were in people over age 65, who qualify for Medicare, which makes colon cancer screenings available for free. Those who have other forms of insurance also can get free colon cancer screenings and other preventive services, due to the Affordable Care Act.

Declines in colon cancer rates became more dramatic in more recent years, falling at an annual rate of 7.2% a year from 2008 to 2010.

Falling rates of colon cancer in older Americans are particularly striking considering that rates of the disease are actually rising slightly in younger people, most likely due to obesity and poor diet, the report says. Colon cancer rates increased by about 1.1% a year in Americans younger than 50. Authors noted that the types of colon cancers found in people under 50 were often those linked to obesity.

About 70% of colorectal cancers are related to lifestyle issues, such as obesity, lack of exercise and eating a lot of red or processed meat, Fuchs says. “Beyond telling people to get a colonoscopy, we need to counsel people to eat a balanced diet and exercise,” Fuchs says.

Americans aren’t benefiting equally, Fuchs says. While colon cancer incidence dropped among all racial groups, the declines were higher in whites than among minorities. And death rates from the disease were 50% higher among blacks than whites, probably because blacks often have less access to healthcare than whites, he says.

Breast Cancer

Cherokee Nation Breast and Cervical Cancer Early Detection Program

To improve access to screening, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990 (PL-101-354), which guided the Centers for Disease Control & Prevention (CDC) in creating the National Breast & Cervical Cancer Early Detection Program (NBCCEDP).

Currently, the NBCCEDP funds all 50 states, The District of Columbia, 5 U.S. Territories and 12 American Indian / Alaska Native tribes including the Cherokee Nation, (see fig. 1.), to provide screening services for breast and cervical cancer.

The program helps low-income, uninsured, and underinsured women gain access to breast and cervical cancer screening and diagnostic services, which include—

  • Clinical breast exams
  • Mammograms
  • Pap tests
  • Pelvic exams
  • Diagnostic testing if results are abnormal Referrals to treatment

In 2000, Congress passed the Breast and Cervical Cancer Prevention and Treatment Act of 2000 (Public Law 106-354). This Act gives states the option to provide medical assistance through Medicaid to eligible women who were screened for and found to have breast or cervical cancer, including precancerous conditions, through the National Breast and Cervical Cancer Early Detection Program.

In 2002, title XIX of the Social Security Act was amended and President Bush signed the Native American Breast and Cervical Cancer Treatment Technical Amendment Act of 2001 (Public Law No. 107-121). This amended bill clarified that Indian women with breast or cervical cancer who are eligible for health services provided under a medical care program of the Indian Health Service (IHS) or of a tribal organization are included in the optional Medicaid eligibility category of breast or cervical cancer patients added by the Breast and Cervical Cancer Prevention and Treatment Act of 2000.

From this the ‘Oklahoma CARES Program’ was implemented January 1, 2005. The overarching objective of the program is that any low income, uninsured woman under age 65, who is identified through the National Breast & Cervical Cancer Early Detection Program (NBCCEDP) and is in need of treatment for breast or cervical cancer (including pre- cancerous conditions and early stage cancer) will be able to receive Medicaid benefits to have her diagnostic and/or treatment procedures paid for.

Oklahoma Cares was designed and implemented cooperatively by five Oklahoma agencies through an interagency agreement. The Cherokee Nation, Kaw Nation, OK State Department of Health, OK Health Care Authority (Medicaid Agency) and the OK Department of Human Services. All five agencies have continued to work collaboratively, since the program’s inception, meeting quarterly, addressing issues and recommending changes as needed.

It was quite an accomplishment for tribes and state agencies to be able to collaborate successfully on such a large project and has proven to be an additional source of reimbursement

for our Cherokee Nation clinics allowing our CNBCCED program to direct more of our program dollars to screening services.

Since beginning in 1996, the Cherokee Nation Breast & Cervical Cancer Early Detection Program has been able to serve over 20,400 women, reimburse for almost 29,000 Pap tests and more than 30,700 Mammograms. Breast cancer is the most commonly diagnosed cancer among women in the Cherokee Nation.

Cherokee Nation BCCEDP Eligibility Criteria is as follows:

  • Proof of Indian descent of a federally recognized tribe, most usually a Certificate Degree of Indian Blood (CDIB) card also referred to as a ‘White Card’.
  • Household gross income not more than 250% above the Federal poverty level.
  • A 2-family household can earn as much as $39,325 annually and still qualify for service reimbursement.
  • Oklahoma residency is not required to be eligible for breast and cervical cancer screening services at any Cherokee Nation Health Facility.
  • Non-OK residents diagnosed with breast and/or cervical cancer, are assured assistance in transitioning to her home state’s Breast and Cervical Cancer Prevention Treatment Act Program with the assistance of a Women’s Health Case Manager.
  • 21-39 years old with history of a bilateral tubal ligation (BTL) or age 40-64 with or without history of a BTL for a Pap test.
  • 40-64 years old for a mammogram.

In addition to the previously mentioned services covered by the CNBCCEDP, patients also receive one-to-one, real-time Case Management when diagnostic follow-up becomes necessary or if cancer treatment is required.

  • Case management plays an integral role in coordinating sometimes many and varied appointments, contacting and educating each patient regarding her appointment, the referral process, and any pre-appointment preparations and provides resource assistance to overcome barriers that may prevent or delay the keeping of an appointment.
  • Assists patient and helps along with the clinic Patient Benefits Advocate (PBA) for an easy transition process into the OK Cares Program for treatment coverage and case management if diagnosed with breast and/or cervical cancer attempting to keep patient’s care timely and as seamless as possible throughout their journey.
  • All Women’s Health Patients receive the same level of care and case management services regardless of CNBCCEDP reimbursement ‘eligibility’. The only difference between a CNBCCEDP-Eligible and a non-CNBCCEDP-eligible patient is payer source.
  • Patients also receive direct patient education from a Health Promotion/Disease Prevention educator during Mobile Mammography Screening Clinics.

CNBCCEDP partners with other Cherokee Nation Health and Cherokee Nation programs:

  • Outreach through a unified message to limit service duplication
  • Maximize outreach efforts to patients who have not accessed the health system within at least the previous 5 years
  • Provide outreach or participate in outreach or in-reach in collaboration with the Program Health Promotion/Disease Prevention educator at Cherokee Nation health facilities, various community events and other activities.
  • Partner and participate in Sequoyah Schools ‘Pink Game’ held in February annually, providing educational outreach to all event attendees and co-hosting a Survivor’s reception and recognition ceremony between games where SHS basketball players and cheer squad present each survivor with a flower and escort them to center court.


E-Cigarette Information

Please feel free to call any Cherokee Nation Health Facility, most toll-free, and ask to speak with a Women’s Health Case Manager for more information about the Cherokee Nation Breast & Cervical Cancer Early Detection Program services, assistance in determining eligibility and making an appointment.

Cherokee Nation Health Facilities

Sam Hider Health Center – Jay, OK:  1-877-293-4271
Three Rivers Health Center- Muskogee, OK:  1-918-781-6500

A-MO Salina Health Center- Salina, OK:  1-877-434-8500

Redbird Smith Health Center- Sallisaw, OK:  1-877-797-9159

Wilma P. Mankiller Health Center- Stilwell, OK:  1-877-747-8800

Will Rogers Health Center- Nowata, OK:  1-877-373-0192

Bartlesville Health Center- Bartlesville, OK:  1-918-336-0823

Vinita Health Center- Vinita, OK:  1-918-323-0194

W. W. Hastings Hospital- Tahlequah, OK: 1-877-838-3100 (OK-only) or 1-918-453-3100

Other Contact Information

Angela Leach, RN, Program Manager

Cherokee Nation Breast & Cervical Cancer Early Detection Program

Contact number:  (918) 453-5756 (office) / (918) 453-8582 (mobile)

Connie Davis, RN, MSN, Executive Director

Cherokee Nation Health Services

(918) 453-5000

PHAB Accredited

PHAB Accredited

How Healthy Are We?

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