Indigenous Peoples cancer survivorship across the world

Indigenous Peoples (AIAN, Aboriginals, Maori) experiences of cancer vary by country of origin, tribal affiliation and tribal geographic region. Most experience difficulties accessing care, managing treatment and side effects, and attaining quality of life (QOL). "Native American Cancer Education for Survivors" (NACES) is a web-based public health education program presented in modules and designed to provide and assess the effectiveness of a culturally appropriate intervention on quality of life of Native American breast cancer survivors. The purpose of NACES is to improve the QOL of cancer patients by increasing knowledge and informed choice using innovative, tailored web-based technology. NACES includes didactic information, video vignettes, storytellers and other cultural components with programming for individualized tailoring. The average literacy level for each module is grades 5-7. While focusing on breast cancer, international survivors of all types of cancer use the website with more than 1,000 accessing the site daily (8.500 daily hits). About 15% are from outside the US. As of January 2008, more than 200 international Indigenous cancer survivors completed the four-part QOL survey describing similarities and differences in their cancer experiences. Users include those newly diagnosed (12.5%) as well as long-term survivors (18.8%), as well as young adults (23 years) and the very old (93 years). About half were younger than 50 at the time of diagnosis. Most have some other type of chronic health condition (high blood pressure, 35%; obesity, 33%; arthritis, 25%; diabetes, 15%). Online evaluation shows the information is well accepted and heavily accessed.