The community outreach and engagement teams from Duke Cancer Institute, Wake Forest Baptist Comprehensive Cancer Center and UNC Lineberger Comprehensive Cancer Center have launched a unique initiative that focuses on understanding and addressing the cancer-related health needs of American Indian communities in their catchment areas and beyond.

Called the Southeastern American Indian Cancer Health Equity Partnership (SAICEP), the three institutions are collaborating on several initiatives within the partnership to address the stark disparities in cancer experienced by American Indian communities in North Carolina. The state is home to the largest American Indian population in the Eastern U.S., represented by eight tribes and four urban Indian centers. 

The SAICEP partnership is co-led by Ronny A. Bell, PhD, MS, director of the Office of Cancer Health Equity at Wake Forest Baptist Comprehensive Cancer Center and a member of the Lumbee Tribe; Tomi Akinyemiju, PhD, MS, associate director of the DCI Community Outreach Engagement and Equity program (COEE); and Stephanie B. Wheeler, PhD, MPH, associate director of Community Outreach and Engagement at UNC Lineberger Comprehensive Cancer Center.

SAICEP will leverage the resources and expertise of the three comprehensive cancer centers in North Carolina and partner with state and federally recognized tribes and urban Indian organizations across North Carolina to co-develop culturally relevant and effective cancer prevention and control initiatives among American Indian tribal communities.

“The striking disparities in cancer incidence and mortality in American Indian tribes in our catchment area is a public health emergency. SAICEP will help us build a strong coalition of community leaders, state and local organizations, and scientists in each of our comprehensive cancer centers for co-learning and co-developing effective strategies to eliminate this disparity,” said Akinyemiju. "Strategies to reduce these disparities must include eliminating cancer-related risk factors such as tobacco use and obesity, as well as ensuring equitable access to quality health care, including regular cancer screening so that cancers can be detected and treated as early as possible."

According to the U.S. Department of Health and Human Services Office of Minority Health, American Indian men are 30% more likely to have stomach cancer compared with non-Hispanic White men, and American Indian women are more than twice as likely to develop and die from liver cancer compared with non-Hispanic White women. American Indian men in North Carolina also have higher prostate cancer mortality rates compared with non-Hispanic White men.

A SAICEP lecture series targeting researchers and providers is already underway and a COVID-19 vaccine event in the Lumbee community is scheduled for Nov. 30, during which informational and educational materials on cancer screening will be provided for community members. A symposium is being planned for 2022 involving American Indian community leaders, researchers, clinicians and various organizations.

The Partnership’s inaugural event, held in September, was a talk on “Meeting the Cancer Prevention and Care Needs of North Carolina’s Indigenous Communities" led by Marc Emerson, PhD (an assistant professor in the Department of Epidemiology at UNC Gillings School of Global Public Health and a member of the Navajo Nation) and SAICEP co-director Bell.

SAICEP’s second event, held on Nov. 17, was a virtual lecture by Rodney Haring, PhD, MSW, on “Building Cancer Care Collaboratives for the Seventh Generation.” Haring, an enrolled member of the Seneca Nation of Indians (Beaver Clan), is director of the Center for Indigenous Cancer Research at Roswell Park Comprehensive Cancer Center, an associate professor of Oncology, a research faculty member with the Center’s Office of Community Outreach and Engagement (Department of Cancer Prevention and Control), and adjunct faculty at the Native American Research and Training Center at the University of Arizona.

Both SAICEP lectures were targeted at academic researchers and clinicians.

Recordings of all SAICEP lectures, when possible, will be made available through the UNC Lineberger Cancer Network Learning Portal at a later date.

Stay tuned for a lecture in the new year by Hannah Woriax, MD, a member of the Lumbee Tribe who recently joined DCI as a Duke Health fellowship-trained breast surgeon and assistant professor in the Duke University School of Medicine Department of Surgery, Division of Surgical Oncology. Woriax is currently practicing at the Duke Cancer Network-affiliated Scotland Health Cancer Treatment Center where she specializes in surgical care for patients with benign breast disease and breast cancer.

The Southeastern American Indian Cancer Health Equity Partnership (SAICEP), is represented by a special cancer ribbon with four distinctive colors — black, red, yellow and white — symbolizing, depending on the tribe:

• each of the four directions: east, south, west, and north 
• the four human races
• the four stages of life: birth, youth, adult (or elder), death
• the four seasons of the year: spring, summer, winter, fall
• the four aspects of life: spiritual, emotional, intellectual, physical
• the four elements of nature: fire (or sun), air, water, and earth
• the four animals: eagle, bear, wolf, buffalo (and many others)
• the four ceremonial plants: tobacco, sweet grass, sage, cedar