David Perdue

Publications (2)7.48 Total impact

• Article: The last frontier: innovative efforts to reduce colorectal cancer disparities among the remote Alaska Native population.

  Diana Redwood, Ellen Provost, David Perdue, Donald Haverkamp, David Espey
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  ABSTRACT: The Alaska Native (AN) population experiences twice the incidence and mortality of colorectal cancer (CRC) as does the U.S. white population. CRC screening allows early detection and prevention of cancer. We describe pilot projects conducted from 2005 to 2010 to increase CRC screening rates among AN populations living in rural and remote Alaska. Projects included training rural mid-level providers in flexible sigmoidoscopy, provision of itinerant endoscopy services at rural tribal health facilities, the creation and use of a CRC first-degree relative database to identify and screen individuals at increased risk, and support and implementation of screening navigator services. Alaska Tribal Health System. AN population. Itinerant endoscopy, patient navigation. AN patients screened for CRC, colonoscopy quality measures. As a result of these ongoing efforts, statewide AN CRC screening rates increased from 29% in 2000 to 41% in 2005 before the initiation of these projects and increased to 55% in 2010. The provision of itinerant CRC screening clinics increased rural screening rates, as did outreach to average-risk and increased-risk (family history) ANs by patient navigators. However, health care system barriers were identified as major obstacles to screening completion, even in the presence of dedicated patient navigators. Continuing challenges include geography, limited health system capacity, high staff turnover, and difficulty getting patients to screening appointments. The projects described here aimed to increase CRC screening rates in an innovative and sustainable fashion. The issues and solutions described may provide insight for others working to increase screening rates among geographically dispersed and diverse populations.
  Gastrointestinal endoscopy 03/2012; 75(3):474-80. · 6.71 Impact Factor
• Article: American Indian/Alaska Native cancer policy: systemic approaches to reducing cancer disparities.

  Donald Warne, Judith Kaur, David Perdue
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  ABSTRACT: Members of American Indian and Alaska Native (AI/AN) tribes have a unique political status in the United States in terms of citizenship, and that political status determines eligibility for certain unique healthcare services. The AI/AN population has a legal right to healthcare services based on treaties, court decisions, acts of Congress, Executive Orders, and other legal bases. Although the AI/AN population has a right to healthcare services, the Indian Health Service (the federal agency responsible for providing healthcare to AI/ANs) is severely underfunded, limiting access to services (including cancer care). In order to overcome distinct cancer health disparities, policy changes will be needed. This paper reviews the historical pattern of AI/AN healthcare and the challenges of the complex care needed from prevention through end-of-life care for cancer.
  Journal of Cancer Education 02/2012; 27 Suppl 1:S18-23. · 0.76 Impact Factor