Earnestine Clark uses a personal example to illustrate why many of her Navajo patients at the Gallup Indian Medical Center are reluctant to get screened for colorectal cancer.
As a girl growing up on the Navajo reservation, Clark’s parents often hitchhiked into Gallup to buy necessities, she said.
“My mother and father didn’t have a vehicle when I was growing up,” said Clark, a registered nurse for the Indian Health Service.
“When they went to Gallup, it was for essentials – groceries and other things we needed at home,” she recalled Friday. “It wasn’t to go to the hospital.”
For people struggling to survive, traveling to Gallup or Shiprock for a colonoscopy can be a low priority, Clark said. The two cities are the only New Mexico sites in the Navajo Nation where the screening test is offered.
Many Navajo, particularly men, also have a cultural bias against seeking medical care, Clark said.
“The myth is, you don’t go to the hospital because that’s the place to die,” she said. “It’s not a place where you are going to get help.”
Clark made the comments during a break at the 2017 New Mexico Colorectal Cancer Roundtable at the University of New Mexico Comprehensive Cancer Center.
The American Cancer Society organized the daylong event to bring together health professionals to discuss ways to reduce colorectal cancer rates.
Colorectal cancer is the fourth leading cancer diagnosis in New Mexico, where 800 new cases are diagnosed each year, said Chuck Wiggins, director of the New Mexico Tumor Registry. About 135,000 new cases are diagnosed annually in the U.S.
The rigors of life on the reservation help explain low colorectal screening rates and rising colorectal cancer rates for Native Americans in New Mexico.
About 61 percent of all New Mexicans are up-to-date with colorectal cancer screenings, compared with 65 percent nationally.
But among Native Americans, only 45.3 percent are up-to-date with screening, said Kevin English, director of the Albuquerque Area Southwest Tribal Epidemiology Center. For Native American men in New Mexico, the rate is only 38 percent, he said.
Colonoscopy is more than a diagnostic procedure for colorectal cancer, English said. If doctors find precancerous polyps, they can remove them during the procedure, he said.
Other effective screening tests offer an option for people reluctant to get a colonoscopy, which requires fasting and preparation that many patients dislike, said Dr. Durado Brooks, a managing director of the American Cancer Society.
Alternatives include a test of fecal samples, called a fecal immunochemical test, or FIT, that costs less than $30 and can detect up to 75 percent of cancers, he said.
“Patients want options,” Brooks said. “The best test is the one that gets done.”