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A Patient’s Perspective on Colorectal Cancer Screening in the Indian Health System

by Chris Mandregan, Director, Alaska Area, Indian Health Service

American Indians and Alaska Natives are uniquely vulnerable to colorectal cancer. That’s why, in Alaska, Alaska Native patients are now recommended at age 40 to get their first colonoscopy, an examination of the gut for suspicious growths. Across the Indian health system, both in federal government operated facilities and in tribal facilities, Tribes and IHS are working together to educate our communities about the benefits of screening to detect any issues while they are easier to treat. I believe that this prevention and outreach is some of the most important work we are doing: let me tell you why.

In 2013, I went in to get my first colonoscopy. After my primary care doctor and I talked about why it was necessary and what to expect, Southcentral Foundation’s Anchorage Native Primary Care Center (ANPCC) scheduled the appointment for me in an operating room at the Alaska Native Medical Center, the beautiful, state-of-the-art hospital run by the Alaska Native Tribal Health Consortium. There was some dietary preparation to clean the intestinal tract a day before the procedure. Then for the procedure, I was mildly sedated, much like a gentle nap, so I don’t remember all that much about it. In terms of pain and inconvenience, it was painless and much easier than I had expected. My spouse was there with me, which made me much more comfortable.

When I was fully alert, I was very surprised to learn that they had found and removed nine precancerous polyps in my intestine. Not one or two, but nine. Imagine if I had delayed a few years instead of following my doctor’s recommendation to get screened.

Thankfully, my issue was caught early so it has not affected me much. I took it easy for a few days after the procedure but was able to return to work the next day. Less than a year later, the ANPCC contacted me to schedule a follow-up colonoscopy. I’m glad to report that the second colonoscopy was completely clear and I do not need to get another for five years. I have shared my experience with my family members, and have convinced at least one who was unsure about the procedure, to go in and have a colonoscopy.

I encourage you to read more about the IHS Strategic Plan to Increase Colorectal Cancer Screening and our work to increase access to lifesaving colorectal cancer screening. IHS also recently launched a partnership with the Roswell Park Cancer Institute to reduce cancer’s impact in Native communities.

Please talk to your family and friends about cancer screening, and whether you get care directly from IHS or in a tribal facility, ask your doctor, mid-level provider or community health aide if you are due for a colonoscopy.

Related Content:

National Colorectal Cancer Awareness Month

Indian Health Service, Roswell Park Launch Partnership to Reduce Cancer's Impact on Native Communities


Chris Mandregan, Director, Alaska Area, Indian Health Service
Chris Mandregan, a tribal member of the Aleut Community of St. Paul, Alaska, serves as Director of the Alaska Area IHS. He earned a bachelor of business administration from Washington State University and a master of public health from the University of Hawaii at Manoa.