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Walking Forward

Cancer Research for Native Americans

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Walking Forward is a research program designed to improve the quality of life for Native American cancer patients and increase cancer survival rates among this population group. Learn more by calling:


Walking Forward is a research program designed to improve the quality of life for American Indian cancer patients and increase cancer survival rates among American Indians in western South Dakota. Native Americans on the Northern Plains have one of the highest rates of cancer deaths in the United States.

In 2002, the Walking Forward program was started when the John T. Vucurevich Regional Cancer Care Institute received a grant from the National Institute of Health, with Dr. Daniel Petereit, a radiation oncologist, as principal investigator.

Goals of Walking Forward

Walking Forward is now a program of Avera, and continues working toward these goals:

Cancer Education: Increase knowledge about the root causes of cancer and related health issues through community discussions and workshops to address concerns and misconceptions surrounding diagnosis, treatment and survivorship.

  • Cancer Screening: Increase cancer screening rates by educating the community about the availability and benefits of screening procedures such as colonoscopies, Pap tests, and mammograms and navigation to these services and resources.
  • Earlier Diagnosis: Increase patient survival rates by earlier detection and presentation of cancer (stage migration), earlier treatment, and ultimately a better outcome.
  • Clinical Trials: Increased enrollment in clinical trials by strongly encouraging Native American patients to participate.
  • Community Navigation: Provide culturally-responsive cancer care navigation services to assist this population from diagnosis through treatment.

Barriers and Challenges

Significant barriers to the above objectives exist within the demographics of western South Dakota:

  • Home to four of the top 10 poorest counties in the U.S., with poverty rates over 45 percent
  • Negative attitudes and mistrust toward local caregivers
  • Travel distance to cancer care: average 145 miles ONE WAY
  • Higher costs associated with treatment such as gas, food and lodging
  • Cultural beliefs regarding medical treatment


Walking Forward has achieved tremendous success as evident from measured outcomes over the last several years, such as:

  • Increased trust among the tribal community
  • Higher participation rate in several clinical trials
  • Higher completion rates for treatment, which often leads to higher survival rates
  • Created research infrastructure including new research partners

Recent data analysis suggests that cancer patients with screen-detectable cancers are now presenting with earlier stages of disease and experience higher cure rates. Walking Forward is also hopeful to step beyond cancer issues and encourage Native Americans of western South Dakota to focus on all health issues, such as smoking cessation, diabetes, and obesity since many of these conditions also increase the risk of cancer.

Live Better. Live Balanced. Avera.

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