Kidney Cancer Disparities Persist Among American Indian and Alaskan Native Patients

American Indian and Alaska Native individuals face some of the highest kidney cancer burdens in the United States. Research indicates that reducing these disparities requires sustained, multi-level action that addresses both medical and social factors.

Data presented this week at the 2025 International Kidney Cancer Symposium highlighted that kidney cancer incidence among American Indian and Alaska Native individuals is approximately 90% higher than among non-Hispanic White people, with rates of 34.2 versus 18 per 100,000 people. Mortality is nearly twice as high in these communities, and kidney cancer ranks among the top five cancers affecting American Indian and Alaska Native populations in many regions of the country.

The study’s authors included Salvatore La Rosa, chief scientific officer of the Kidney Cancer Association in Houston, Texas, and colleagues. La Rosa holds a PhD in medicinal chemistry and has been involved in research on kidney cancer disparities.

According to the researchers, from 1999 to 2020, kidney cancer incidence in American Indian and Alaska Native men and women rose two to three times faster than it did among White individuals. Between 2009 and 2018, incidence rates increased by 2.8% per year for American Indian and Alaska Native patients, compared with 1.1% per year for White patients.

Death rates were also significantly higher, approximately double that of White patients. Five-year survival was lower, at 71% for American Indian and Alaska Native individuals, compared with 76% for White individuals. Researchers noted that national improvements in mortality have not been experienced equally, with American Indian and Alaska Native communities lagging behind. They suggested this disparity is largely due to late detection and limited access to novel immuno-oncologic therapies.

The study also found that American Indian and Alaska Native patients are more likely to be diagnosed with advanced disease, less likely to receive surgery or systemic therapy, and have poorer survival even after accounting for cancer stage and other health conditions.

Researchers emphasized that these disparities are the result of multiple factors. Clinical and biological contributors include high rates of obesity, hypertension, chronic kidney disease, and tobacco use. Environmental exposures, social and structural determinants, and cultural and historical barriers also play a role in shaping these outcomes.

According to the findings presented at the meeting, reducing disparities will require coordinated, multi-level actions. Prevention efforts should target obesity, tobacco use, hypertension, and diabetes through culturally relevant programs. Early detection should be supported by improving access to imaging and implementing risk-stratified screening. Healthcare access can be enhanced through modernization of Indian Health Service (IHS) facilities and expansion of tele-oncology. Environmental health initiatives should monitor and mitigate contaminant exposure, incorporating community-driven strategies. Programs should also integrate traditional healing practices, respect tribal sovereignty, and empower tribal nations to collect, manage, and use health data to inform equitable policies.

The researchers emphasized that “with community-led leadership and adequate funding, even small reductions in smoking, obesity, or late presentation can translate into lives saved and help narrow long-standing health gaps.”

Practical interventions to improve healthcare access and quality include increasing IHS and tribal facility funding, bringing specialists to communities through outreach and telehealth, expanding Medicaid, providing patient navigation services, and offering culturally competent education and support.
Individuals can also take steps to reduce their risk of developing kidney cancer. The Kidney Cancer Association recommends not smoking, following medical guidance for managing high blood pressure or chronic kidney disease, adopting healthy habits to prevent obesity and diabetes, maintaining a balanced diet, staying physically active, managing stress, and remaining actively engaged with healthcare providers.

By addressing these challenges at both the community and individual levels, researchers hope to reduce kidney cancer disparities and improve outcomes for American Indian and Alaska Native populations across the United States.

References

1. “Kidney Cancer Trends, Risk Factors, and Interventions in American Indian and Alaska Native Populations” by Salvatore La Rosa, et al. Presented at: 2025 International Kidney Cancer Symposium ; Nov. 13-15, 2025; Denver, Colorado. Abstract B4.
2. “American Indians and Alaska Natives,” Kidney Cancer Association; https://www.kidneycancer.org/populations-at-higher-risk/american-indian-alaska-native/

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