"Nobody Is Talking About It": Dine (Navajo) Communities Speak About Stomach Cancer andHelicobacter pyloriInfections

Stomach cancer is the third leading cause of cancer death globally.Helicobacter pyloriplays a role in the healthy human gut, but is also associated with multiple chronic diseases, including stomach cancer. ThoughH. pyloriprevalence is declining in parts of the world, it remains high among certain populations. In Arizona, stomach cancer rates are 3-4 times higher among the Navajo Nation population as compared with the non-Hispanic white population. This pilot project assessed adult Dine (Navajo) individuals' understanding and awareness regardingH. pyloriinfection and stomach cancer. Focus groups were held in three Dine communities. Data were analyzed thematically using a multi-investigator consensus approach. Participants had limited knowledge ofH. pyloriinfection and stomach cancer and perceived local medical providers as also having limited knowledge on these conditions. Participants described poor health care experiences, structural inequalities, and environmental concerns and associated these withH. pyloriinfection and stomach cancer. This study highlights the need for additional research and education on current knowledge and perceptions of stomach cancer andH. pyloriinfections in Navajo Nation.