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If things go the way Dr. Daniel Petereit plans, fewer Native Americans in South Dakota will die from lung cancer.

It’s a vision that started 16 years ago when Petereit, a radiation oncologist at Regional Health–John T. Vucurevich Cancer Care Institute, first began to delve into some of the issues facing the Native community and cancer detection and treatment. Native Americans have the highest rates in the U.S. for lung cancer, a fact that has moved Petereit to action.

“It’s the reason you first go to medical school,” Petereit said. “You’re trying to make a difference.”

His latest work — to increase lung cancer screening rates for high-risk smokers in western South Dakota — was boosted by a $1.6 million award from the Bristol-Myers Squibb Foundation.

The funding will go to the Walking Forward program, a cancer disparity project funded through the National Cancer Institute to address the high cancer mortality rates among Native Americans in western South Dakota. Petereit is the principal investigator of Walking Forward, which was started in 2002, and the new research will address the entire West River population.

The award will be distributed over three years and will fund the program’s research and efforts to increase access to advanced lung screening technology. The scans, called low dose computed axial tomography (LDCT) scans, can screen and diagnose lung cancer sooner, resulting in earlier treatment and lower mortality rates.

In the past, only about 4 percent of the national population have utilized the screens and only 1 to 2 percent in South Dakota, Petereit said. With the funding, about a dozen South Dakota sites will offer LDCT scans.

“It has the potential to lower lung cancer death rates,” Petereit said. “This is very curable if caught.”

Gaining the community's trust

As part of the study, the Walking Forward team will offer health care providers and clinic staff educational opportunities to help them better identify and refer high-risk tobacco users to LDCT lung cancer screenings. They will also host community workshops for people who are considered high risk for developing lung cancer about the importance and availability of lung cancer screening. That education hinges on relationship, Petereit said.

“It’s gaining trust in the community,” he said. “I’m a white oncologist going to the reservations, and they’re thinking, 'What do you want?' You do a good job and take care of patients, and you will gain that trust.”

A majority of the Walking Forward staff are Native, Petereit said, which means they have a great insight into community needs and how to best reach people who might not be open to a cancer screen or treatment.

“If we’ve made a difference, it’s our staff in the community,” Petereit said.

Petereit’s interest in Native American health began at a young age as he grew up in Sioux Falls and fished along the banks of a river with Native American friends. His commitment to serving the public, he said, came from his father, who grew up in poverty in Nebraska and went on to become a physician.

“He had to grit his way through,” Petereit said.

Petereit spent 10 years in the Department of Human Oncology at the University of Wisconsin before moving to Rapid City in 1999, where he started working with the Northern Plains Native Americans as part of Walking Forward.

The program has addressed disparities through patient navigation, clinical trial access, and identification of barriers to early detection and successful treatment.

“Fifteen percent of the patients we serve are Native,” Petereit said. “This is a perfect fit."

Walking Forward recently completed a smoking cessation project. A controlled trial involving 256 Native Americans included interventions of nicotine replacement, counseling, and text messaging to mitigate the high rates of tobacco use, and tobacco-induced cancers. Twenty-five percent of the participants were smoke free after six months. 

It’s exciting to see success, Petereit said.

“It’s gratifying to work with a community, find an issue and make a difference,” he said.

Walking Forward is housed at Avera Health in Sioux Falls and is operated in collaboration with Regional Health in Rapid City. For more information visit

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