The Centers for Medicare & Medicaid Services selected the Salt Lake City center as one of six sites for projects on early detection and treatment of cancer for minority Medicare beneficiaries. The institute will focus on American Indians living in eleven tribal locations throughout Utah, and three tribal locations in north-central Montana.

Randall Burt, interim executive director and principal investigator on the $3.9 million project, said the center's geographic location was a persuasive factor in getting the grant.

"Not only do we have several Native American populations within the Intermountain West that we can enroll, but many of them live in what is termed a 'frontier' area, where there may be six or fewer people per square mile," he said. "This geographical remoteness adds an additional layer of difficulty to people already having problems accessing health care."

Researchers will examine how to best ensure American Indians on Medicare living in rural and frontier areas get the appropriate screenings for breast, cervical, colorectal and prostate cancer.

A total of 13,000 members of minority populations now on Medicare will be enrolled from all six sites. The Huntsman institute's goal is to enroll 1,800 American Indians from the Utah and Montana locations, with the Sletton Cancer Institute at Benefits Healthcare in Great Falls, Mont., assisting with recruitment.

Dena Ned, executive director of the Indian Walk-In Center in Salt Lake City, said the rural population is severely underserved.

"They have limited health care," she said. "Most of the clinics are underfunded and hard to get in. I think there's a need in all aspects to address the disparities in Indian country. We don't know what the prevalence of cancer is because we're either misidentified as nonnatives or we're overlooked."

The study will hire about 40 "navigators," people who will reach out to various tribal areas to enroll participants. Most likely, the navigators will be from those communities and have some background in health care, said Randall Rupper, an investigator for the institute and the VA Salt Lake Geriatric Research Education and Clinical Center.

Ned said using local residents or others known on reservations would be advantageous.

"It would take a while for people to open up if it's a stranger," she said. "It helps if they know somebody or they've worked with Indians before so there's trust."

Rupper said investigators will contact tribal councils to obtain navigators, whom he expects will be trained and ready to enroll people by the end of summer.

"Our focus is to get out into the communities," Rupper said. "The navigators will be in people's homes and in clinics."

He believes lung cancer, related to smoking, is the most prevalent cancer for American Indians, followed by higher-than-average rates of prostate and breast cancers.

"The American Indian populations have faced a lot of challenges in getting care for cancer," Rupper said. "If they have cancer, we'll navigate them through any barriers to treatment, whether it's help with transportation, translation and interpretation services, or care coordination, so they can receive the most beneficial therapies."

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Contact Carey Hamilton at chamilton@sltrib.com or 257-8605. Send comments to livingeditor@sltrib.com.

Improving minority cancer care

The Huntsman Cancer Institute will study how to improve cancer screenings and care for rural American Indians. Other sites and minority groups to be enrolled in the national study:

* Molokai General Hospital in Hawaii, studying Asian-American and Pacific Islander care;

* University of Texas, studying Hispanic-Mexican American care;

* New Jersey Medical School, studying Hispanic-Puerto Rican care;

* Johns Hopkins University in Maryland, studying care for blacks;

* Josephine Ford Cancer Center in Michigan, studying care for blacks.