Project Leader:  Dr. Sarah Nash | Alaska Native Tribal Health Consortium

Abstract

Colorectal cancer (CRC) is the third leading cancer among Alaska Native (AN) people, and the second leading cause of cancer death. Both incidence of and mortality from CRC is twofold higher among AN people than among US whites; this disparity has persisted for over 30 years. To fully address CRC disparities among AN people, a holistic approach must be used whereby secondary prevention methods are complemented by a thorough understanding of etiology. However, while CRC screening initiatives, particularly at the Alaska Native Tribal Health Consortium (ANTHC) have been very successful, risk factors for CRC remain understudied. While risk factors for CRC among AN people likely mirror many of those observed in other populations, there may also be unique factors that must be explored.

This proposed research program will conduct a thorough assessment of genetic, genomic, and lifestyle risk factors for CRC among AN people by establishing a case-control study recruiting through the Alaska Native Medical Center (ANMC) Surgery Clinic. The current Developmental Phase of the research will provide time to elicit critical feedback from tribal, clinical and other stakeholders regarding the development of the case-control study.

Specifically, we wish to engage tribal and other stakeholders around best practices for genetic and genomic research, including questions around informed consent, collection and storage of biospecimens, and data sharing and dissemination. We will also elicit feedback from tribal, clinical, research, and other stakeholders across the Alaska Native Health Campus to inform logistical aspects of the case-control study design, including study recruitment, questionnaire development, and access to archived biospecimens. Lastly, this developmental phase, and the input from tribal and clinical stakeholders, will be used to inform and develop study materials including recruitment flyers, informed consent documents, and the demographic, family history, and lifestyle questionnaire.

The primary deliverable from the current Development Award application will be an AAIRB and tribally approved case-control study protocol which will be submitted to the AIAN-CTRC for pilot funding in 2017. This pilot phase of the research will demonstrate feasibility of case-control recruitment, as well as the potential of genetic and genomic research among AN people.

The overall goal of this proposed research plan is to develop a comprehensive, community-engaged study of risk factors for CRC among AN people that will be funded through NIH R-series awards. Led by ANTHC, this research will be conducted in close collaboration with investigators from the Fred Hutchinson Cancer Research Center (FHCRC) that have extensive experience leading studies to investigate genetic, genomic, and lifestyle risk factors for CRC among other populations.