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Deborah Rogers, MS and Daniel G. Petereit, MD

Deborah Rogers is with Rapid City Regional Hospital, Rapid City, SD. Daniel G. Petereit is with the John T. Vucurevich Cancer Care Institute, Rapid City Regional Hospital, Rapid City, SD, and the Department of Human Oncology, University of Wisconsin, Madison.

Correspondence: Requests for reprints should be sent to Daniel G. Petereit, MD, John T. Vucurevich Cancer Care Institute, 353 Fairmont Blvd, Rapid City, SD 57701 (e-mail: dpetereit{at}rcrh.org).

Native Americans served by the Aberdeen, Billings, and Bemidji areas of the Indian Health Service (IHS) have a cancer mortality rate approximately 40% higher than that of the overall US population. The National Cancer Institute has funded Rapid City Regional Hospital to provide clinical trials, behavioral research, a genetic protocol, patient navigator services (assisting patients with health care coordination and financial issues and helping them to understand their options), and community education for members of 3 western South Dakota tribes.

Challenges faced by the project included obtaining multiple approvals from 3 tribes, 4 IHS facilities, and 5 institutional review boards; travel distances; lack of screening; red tape of referrals; and refusal by some payers to cover clinical trials. Building trust through ongoing communication and community presence is key to a successful project.

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