Characteristics of cancer in the Eskimos of Southwestern Alaska.

Abstract

Using records from the Public Health Service Alaska Native Hospital at Bethel, Alaska, the author reviews all known cancers occurring among the Yupik Eskimos of Southwestern Alaska during the 101/2 year period from July 1957 through December 1967. Since this facility is the source, direct or indirect, of virtually all medical care provided to a well-defined population, these records can be used for a reasonably accurate estimate of incidence, mortality, and other epidemiologic characteristics of cancer in this group. The 85 tumors in the series give a crude incidence of 82.4/100,000 for males and 106.3/100,000 for females. Forty-six per cent of the total number originated in the alimentary tract. In both sexes, the commonest cancer site was the esophagus. Another common site in both sexes was the kidney, as was the thyroid in females. There were 45 deaths from cancer, including one person with two separate advanced malignancies. Standardized mortality ratios for cancer were calculated for the Eskimos and other populations based on the U.S. Caucasian death rates for 1962. Those for Yupik Eskimo males and females were 73 and 79, respectively (U. S. Caucasian = 100), for histologically proven cases and 84 and 94, respectively, for all diagnosed cases. A comparison of observed with expected cancer deaths (based on U.S. Caucasian rates for 1962–63) revealed a great excess of esophageal cancer in the Eskimos of both sexes. Further study of this problem, with particular reference to possible causative factors in traditional Eskimo cultural practices, seems warranted. Despite widespread opinion to the contrary, cancer is a relatively common disease in Eskimos and an increasingly serious and expensive health problem in the north.