Avera McKennan

Avera McKennan will receive $1,616,255 over three years to implement a pilot program Increasing Lung Cancer Screening for High Risk Smokers in a Frontier Population and investigate the effectiveness of increasing lung cancer screening among high-risk smokers in the medically underserved frontier population in western South Dakota, a region which is primarily comprised of low income whites and American Indians living on reservations and in rural communities. This type of education and research of its effectiveness has never been done within this population and will aid in producing evidence-based policy recommendations that are specific to serving this vulnerable group.


A recently published study clearly identified the disparities in American Indian all-cancer death rates compared to whites. For men in the Northern Plains (1999-2009), death rates due to cancer were 223 (per 100,000) for whites and 338 for American Indians. The difference was similar in women, with death rates of 154 for whites and 247 for American Indians. The study reported that lung cancer mortality rates for Northern Plains American Indians were the highest in the nation: 95.0 American Indians compared to whites (55.3) and to all American Indian/Alaska Natives (49.7). Data collected between 2009 and 2015 at the Regional Cancer Care Institute in Rapid City, South Dakota, also revealed the same trends for NSCLC: while there was no statistically significant difference between whites and American Indians presenting with stages I-III disease, the proportion of American Indians diagnosed with stage IV was significantly higher.


The study will target and compare interventions to increase awareness of lung cancer screening given to two primary groups: health care providers and high-risk current or past smokers between the ages of 55-77 years old in western South Dakota. The health care provider intervention will include education to approximately 135 primary care providers and staff in 30 clinics to improve awareness of and capacity to identify and refer high-risk tobacco users to LDCT lung cancer screening.

Project Leader

Michele Sargent, michele.sargent@avera.org