The inclusion of tribes and American Indian and Alaska Native People in State comprehensive cancer control plans

Purpose: State and District Comprehensive Cancer Control (CCC) plans often do not include priorities for all individuals within their state or district borders. In particular, American Indian and Alaska Native (AI/AN) people experience persistent cancer disparities, yet their inclusion in CCC plans has not been examined. Our study systematically reviewed state and district CCC plans for the inclusion of Tribal-specific cancer control strategies and priorities. Methods: A collaborative team of researchers from Tribal serving organizations, cancer centers, and academic institutions conducted a content analysis of state CCC plans to assess terms, concepts, context, and goals related to Tribal populations across twelve domains. Results: Seventy-three percent (n = 37) of state CCC plans addressed at least one of twelve domain criteria, while 14 states (27%) did not mention Tribal data or priorities. Specifically, the terms “Indigenous or Native” (n = 29) or “American Indian, Indian Country, Reservations, or Indian Health Service” (n = 27) were referenced most often. Three states met the highest domain criteria (New Mexico, California, Montana). Six states with federally recognized tribes within their borders did not meet any domains (Alabama, Florida, Massachusetts, Missouri, Texas, Virginia). Conclusion: By highlighting state and Tribal CCC plans’ best practices and incorporating Tribal priorities within state and district CCC plans and programs, we underscore the importance of addressing cancer in Tribal populations across the U.S. and offer examples of inclusive CCC plan development and implementation.