Native and Indigenous Populations and Gastric Cancer: A Worldwide Review.

Abstract

Gastric cancer is a worldwide concern, particularly for Indigenous populations who face greater disparities in healthcare. With decreased access to screening and critical treatment delays, this group is experiencing adverse health effects. To determine what factors drive these disparities, a systematic review was performed in PubMed. This revealed a lack of research on gastric cancer specific to this population. The literature primarily focused on subset analyses and biological aspects with sparse focus on determinants of health. The results informed this presentation on factors related to Indigenous gastric cancer, which are influenced by colonialism. Indigenous populations encounter high rates of food shortage, exposure to harmful environmental agents, structural racism in the built environment, H. pylori, and compromised healthcare quality as an effect of colonialism, which all contribute to the gastric cancer burden. Putting gastric cancer into a cultural context is a potential means to respond to colonial perspectives and their negative impact on Indigenous patients. The objective of this manuscript is to examine the current state of gastric cancer literature from a global perspective, describe what is currently known based on this literature review, supplemented with additional resources due to lack of published works in PubMed, and to present a model of gastric cancer through the lens of a modified medicine wheel as a potential tool to counter colonial healthcare perspectives and to honor Indigenous culture.