Aleut

Aleut Eskimos who died between 1822 and 1836 are recorded with their age.

Fortunately I have long been in touch with the Moravians and their records. The records of the Russians, however, pertained to a field I had never much cultivated — the Aleut Eskimos. So I appealed to my friend Professor William S. Laughlin of the Department of Anthropology, University of Wisconsin. He replied from Madison on March 14, 1958:

“First, I should like to call your attention to the splendid table in Veniaminov, Vol. II, table 4, in which ages of those who died between 1822 and 1836 are given ...

“I have seen a number of skeletons of advanced age at death. Thus, one Aleut from Umnak Island gave every evidence of being over 80 years of age. I do not have enough records of this sort to be of much statistical value. They do serve to confirm my belief in the validity of local traditions about aged persons ...

“Concerning Anaktuvik persons [inland Alaska Eskimos] I have the list of birth places and birth dates which Mr. Robert Elsner of the Aeromedical Laboratory kindly made available to me. The number of aged men was notable, as was the absence of aged women ...”

Here Professor Laughlin goes into the details of a study being made jointly by himself and Professor Leopold Pospisil of Yale's Department of Anthropology on a small group of inland Eskimos at the Anaktuvik Pass. Of this group one subgroup of 8 consists of men all of whom were born during or before 1900, all thus 58 years old or older.

When I finally got around to formulating this chapter I wrote Professor Laughlin again. He replied on February 4, 1959:

“Concerning the diet of the Aleuts, we can happily document the fact that not only were they living on fish and sea mammals in the time reported (Veniaminov, Vol. II) but they still have a diet which is heavy in flesh foods ... The Aleuts still depend on salmon, sea lion, seal and store foods, in this descending order.”

Veniaminov's table, from which Professor Laughlin sent extracts, is for the Unalaska district of the Aleutians only, and records 1,170 deaths:

“For the period 1822-36 inclusive, the following numbers died: 92 for ages 1 to 4; 17 for ages 4 to 7; 41 for ages 7 to 15; 41 for ages 15 to 25; 103 for ages 25 to 45; 66 for ages 45 to 55; 29 for ages 55 to 60; 22 for ages 60 to 65; 24 for ages 65 to 70; 23 for ages 70 to 75; 11 for ages 75 to 80; 20 for ages 80 to 90; 2 for ages 90 to 100.”

Further evidence of old age Labrador Eskimos exists.

 On receiving Professor Laughlin's letters, I sent copies of them along to Superintendent the Reverend F. W. Peacock, M.A., Moravian Mission, Labrador. His records go back well toward 1771, the founding date of the mission; and there are several stations. Knowing that I had available only limited comparison figures for the Aleutians, he sent me only records from his Hopedale community and covering only the same years as Veniaminov's. 

Superintendent Peacock's letter is dated at Happy Valley, Labrador, March 25, 1959:

“Upon receipt of your letter I went to the records of the Hopedale [mission] from 1822-36. I discovered that 

110 people were born during this period ... 

29 died before reaching the age of 10 years; 

9 died between the ages of 11 and 15; 

4 between the ages of 16 and 20; 

6 between 21 and 25; 

7 between 26 and 30; 

10 between 31 and 35; 

4 between 36 and 40; 

8 between 41 and 45; 

2 between 46 and 50; 

10 between 51 and 55; 

4 between 56 and 60; 

4 between 61 and 65; 

8 between 66 and 70; 

4 between 71 and 75; 

1 reached the age of 79.

“From 1860 to 1879 there were 150 births in the same district, of which number 79 died before they were 5 years old, and a further 10 before they were 10 years old. Another 30 died before they were 60 years old; 30 died between the ages of 61 and 82. One is still living at the age of 81 [in March 1959] ...”

We have examined, then, the mortality records of 1822-36 for 1,170 cases from Alaska and 110 from Labrador. The base line of our immediate concern we shall take at 60, because of the assertion that “a primitive Eskimo over the age of 50 is a great rarity.”

According to our Russian information on 1,170 Aleutian Eskimo births, 46 died in the decade immediately past 60, 34 in the one past 70, 20 in the one past 80, and only 2 lived past 90.

According to our Moravian information on 110 Labrador Eskimo births, 8 died in the decade next past 60 and 5 in the one next past 70, only one of these reaching 79.

Thus the most nearly “primitive” sample group I was able to obtain does not support Dr. Keys very strongly in his contention that “a primitive Eskimo over the age of 50 is a great rarity.” Nor does it quite confirm Dr. Greist's statement that “the Eskimo of the North ... lived to a very great age.” More nearly do the largely non-Europeanized natives of Veniaminov and Peacock accord with the Biblical: “The days of our years are threescore years and ten ..

Dr Romig was finding cancer in modernizing native families.

The territory most specifically observed by Romig is Temperate Zone southwestern Alaska, south of the Yukon River and west of a line drawn north from Seward and Anchorage to Fairbanks. The Europeanization of these parts started in the 1740's, soon after Bering's visit, and was intense in the Aleutians and along mainland Alaska's south coast and the southern west coast. There were little-touched sections, particularly the west coast farther north than the Kuskokwim; and then the interior, which is forested and chiefly inhabited by Athapaska Indians. So there were districts and families that had been “modernized” even before Romig first came; but there were others still so primitive that we might consider them untouched by such influences as those of European foods and food-handling methods. Which these little-influenced spots were, the medical missionary, when of sympathetic temper, would soon know. The total population, before the 1900 measles epidemic, would have been considerably more than 10,000; after the measles, considerably less.

During his first seven years, 1896-1903, Romig worked from Bethel, the Moravian mission on the lower Kuskokwim. He traveled considerably, by dog team in winter and canoe or launch in summer. His patients were chiefly Aleuts, Eskimos, and Athapaskans; but there was a scattering of Russian and other European whites, and of Chinese, Japanese, and Negroes. Some native women were married to these immigrants. They and their children were the chief modernized elements among whom — as among the immigrants themselves — Romig was now and then discovering malignancy cases.

Eskimo natives had a range of cooking styles and mostly carnivorous diets but did not suffer from cancer until modern foods entered their diet.

In reply to a further query, the rector wrote again from Sitka on September 16, 1958. He confirmed that he had lived at Anvik all but three of the years between his birth in 1895 and his first journey in 1908 when he went out to become a graduate of Middlebury College, Vermont. “I returned to Anvik as a missionary in 1922 and lived there until 1948, except for furloughs and the four years I was in Fairbanks.

“The native people of the Anvik area are Athapaskans. During my youth the main parts of their food were meat (caribou, rabbits, grouse, waterfowl, beaver, porcupine, black bear and lynx) and fish (salmon, whitefish, shellfish, loche and lampreys). The loche has a large liver which is said to be even richer in vitamins than ordinary cod liver. The Indians also ate raw foods such as berries, wild rhubarb, and a root which they called ‘mouseberries’ because it was gathered and hoarded by field mice.

“They obtained fat from caribou, black bear, and beaver tails. The lampreys were rich in oil, which was highly prized. They also bought seal oil from the Eskimos. Even in my boyhood they supplemented their native diet with white man's food, including lard ...

“The usual way of cooking meat was either boiling or frying. As a boy I was once invited by a party of Indians to eat bear meat with them. It was boiled and well done ... I do not know that any flesh foods were eaten raw, except for dried fish ...”

Neither does the published literature on the forest Indians report that any flesh foods were customarily eaten raw by the forest Indians of Alaska or northern Canada. Indeed, the name “Eskimos” is believed by many to have been derived from an Algonquin expression meaning “they eat their meat raw.”

When I went down north along the Mackenzie, in 1906 and 1908, I now and then heard talk of how horrified the Athapaskans had been when they first saw white men of the Northwest Company and Hudson's Bay Company eating the customary British underdone roast meats. In 1910, when we met the Athapaskans northeast of Great Bear Lake — Dogribs, Slaves, and Yellowknives — we found that they were still mildly horrified to see the Hudson's Bay Company Canadian Joseph Hodgson and the Old Country British John Hornby and Cosmo Melvil, who were then living among them, eating rare caribou steaks and roasts.

In a presentation of evidence regarding the views of frontier doctors on the incidence of cancer, it is of consequence to make clear that early testimony regarding the rarity or absence of malignancies is as clear and strong for the forest Indian north as for the grassland Eskimo country. Some of the early medical missionaries — notably Dr. Hutton in Labrador — have inclined to credit a diet of raw flesh with that former absence of cancer in which they believed. To emphasize this point let me quote again Dr. Hutton's book Health Conditions (1925), Page 35:

“Some diseases common in Europe have no t come under my notice ... Of these diseases the most striking is cancer ... In this connection it may be noted that cookery holds a very secondary place in the preparation of food — most of the food is eaten raw ...”

If only Eskimos are considered, in relation to the alleged former absence of cancer, and of these only the Labradorians, then the logical deduction for one who believes nutrition to be fundamental in relation to malignancy, is that actual rawness of food may be the crucially important cancer-inhibiting factor. But the force of this logic diminishes as we go westward from Labrador, among the Eskimos. Without cancer's appearing at all, cooking grows steadily more important as we move west. From Dr. Hutton's and other accounts, the Labradorians, east of Hudson Bay, were the greatest raw-flesh eaters of the whole Eskimo world. West of the Bay the boiling of flesh increases; and inland from the Bay, among the Caribou Eskimos, the roasting of caribou supplements the boiling. At Coronation Gulf, near where Dr. Jenness and I spent the first years during which the Copper Eskimos ever associated closely with Europeans, the years 1910 to 1915, there was considerable summer use of roasting, though the winter cooking, if any, was by boiling. Among the Mackenzie Eskimos, as described from the 1860's by Father Emile Petitot and from the early 1900's by myself, boiling and roasting were both considerable. These methods were even a bit more common in northern Alaska, as described by John Simpson in the 1850's and Murdoch in the 1880's. In southwestern Alaska as described by Dr. Romig in the manuscript he submitted to our Encyclopedia Antarctica, for the last decade of the nineteenth century and the first one of the twentieth, the cooking of flesh foods reached its Eskimo high point.

Yet the mission testimony, starting from Labrador, remains equally clear, from east to west: the medical missionaries all looked for cancer, and they never found it among the “primitive,” though they did find it among the “modernized.”

Thus clarification is important for whoever expects a nutritional key to this Eskimo cancer situation. Among the Athapaska and western Eskimos cooking was hardly ever carried to the point of “well done,” or “boiled to pieces.” Instead the native meats resembled our fashionable roasts, which have a well-done layer on the outside, medium done just under that, and the center pink or red. And so it was with the forest Indians — at least with those Athapaskans from Great Bear Lake to just west of the Mackenzie, with whom I hunted and lived — though they insisted on some cooking, they were in practice as careful as Eskimo cooks to see that the centers of most pieces were pink.

To sum up the raw and cooked-food elements of northern medical missionary theorizing about cancer:

During the time when large numbers of non-Europeanized northern natives were allegedly free of cancer, there was little cooking of flesh foods beyond the degree which we call medium. Among grassland and coastal Eskimos raw flesh eating ranged from a great deal in northern Labrador to a good deal in southwestern Alaska. Only among forest Indians were raw flesh foods avoided, and even among these there was little use of overcooked flesh.

Vegetable foods, where eaten at all, were always raw, among prairie and woodland natives alike. Among Eskimos, vegetable foods were important only in the farthest west — along the west coast of Alaska, among the Aleutians, and along the south coast of Alaska. In the most northerly region from Baffin Island, Canada, to Point Barrow, Alaska, vegetable eating was negligible, except in time of famine. Among woodland Indians, vegetables were negligible with the Athapaskans from the west shore of Hudson Bay to beyond the Mackenzie. In Alaska the eating of raw vegetables by forest Indians increased westward along the northern belt and then increased still more southward, into the country of the Tlingit.

During the time when the medical missionaries reported cancer difficult or impossible to find among large numbers of primitive natives, there was no usual cooking of any vegetables, whether among grassland or forest natives. The cooking of vegetables is part of that Europeanization which is considered by some missionaries to be responsible for the introduction of cancer, or for the change from its being hard to find to its being impossible not to notice.

The European-style application of intense heat to food through frying was new to all northern North American natives.

The man who started the search for cancer.

It was probably at the Arctic Red River (where on July 20, 1906, I first saw an Eskimo) that I first heard of Captain Leavitt, who, I found later, was known on the lower Mackenzie, as well as on the shores of the western Canadian Arctic, as “the man who started the search for cancer.” Or perhaps I first heard of Leavitt the next day, July 21, at Fort McPherson, where I met John Firth, Hudson's Bay Company factor, destined to be my friend until his death two decades later. In later years we talked a great deal of Leavitt, whom Firth admired, and whose search for cancer in northeastern Siberia, the Aleutian Islands, Alaska, and northwestern Canada, led a half century later to the writing of this book.

Judicial Divisions in Alaska show more cancer for more civilization in a 5 year U.S. Treasury Public Health Report for 1926 - 1930.

 Obviously, from the testimony presented so far, the frontier doctors of Alaska and northern Canada would have expected that statistics, if and when published, would confirm their view that the most civilized parts of northern territories would show the highest cancer incidence.

The chance to test this theory against the facts of statistically adequate population, and for a large and culturally differentiated area, did not come until the U.S. Treasury's Public Health Reports for March 2, 1934, carried “Mortality in the Native Races of the Territory of Alaska, with Special Reference to Tuberculosis," by F. S. Fellows, Passed Assistant Surgeon, United States Public Health Service, and Director, Alaska Medical Service.

The discussion by Dr. Fellows does have “special reference to tuberculosis.” But “malignancy" receives a column in the statistical tables, from which we can readily derive the information we need. The time covered is the five years 1926-30; the population, by the 1930 census, was around 60,000, about evenly divided between natives and whites, thus about 30,000 of each. As to causes of death, Dr. Fellows compares natives with whites and each of the four judicial divisions of Alaska with the other three. For my analysis of his cancer results I shall arrange the divisions in descending order of Europeanization. With an eye on the map (p. 91) and bearing history in mind, we may characterize the judicial divisions as follows:

Most intensively and longest civilized is the First Judicial Division, the Panhandle that stretches southeasterly along British Columbia. Its first European contacts were probably with Spain through Mexico in the 1500's. After Bering's voyage in 1741 the capital of Russian America was established at Sitka, where it remained even for some decades after the over-all name was changed to Alaska through purchase by the United States in 1867. Both before and after 1776 Yankee influence was considerable, as was British. After the purchase the influence of San Francisco was at first dominant, until Seattle and Vancouver took over.

Since the forest Indians of the Panhandle have been civilized the longest and most intensively of native Alaskans, the First Judicial Division ought to show the heaviest cancer incidence, according to the views of the frontier doctors whom we have quoted. That is the theory. Let us turn to statistics and seek the facts.

Table 2 of the Fellows paper is entitled “Actual and relative mortality from important causes among the native Indians and Eskimos and among the white population of Alaska during the five years 1926-30.” In the first third of this table, under “Average annual death rate per 100,000,” we find in the column marked “Malignancy” that in the First Judicial Division the white deaths from cancer are 92, the native 70. In the middle third of the table, under “Percent of all deaths due to indicated cause,” we learn that the white percentage from cancer was 7.8, the native 2.8. In the lowest third of the table, under “Number of deaths,” we learn that the whites who died of cancer were 59, the natives 21.

Map showing judicial divisions of Alaska

Historically the Third Judicial Division of Alaska ranks second among the divisions in Europeanization. It consists of the Aleutian island chain and of the southwestern corner of the mainland. Russian influence in the islands dates as far back as in the Panhandle, but the mainland part of the division was never intensively Europeanized. By the Tanchou-Le Conte principle, the native cancer rate should be fairly high but not as high as that of the Panhandle. According to Fellows' Table 2, the cancer figure per 100,000 is 75 for whites and 22 for natives; in percentages the whites rate 6.0 and the natives 1.4; in actual cancer deaths the whites have 33 and the natives 8.

The Second Judicial Division, from its history, should be in native cancer deaths the next to the lowest of the judicial districts, by the frontier theory. According to the tables of Dr. Fellows the per hundred thousand rate is white 126 to native 14; in percentages it is white 10.8 to native 0.8; in actual deaths the white are 9 to the native 6.

The Fourth Judicial Division should be lowest of the four in native cancer deaths. Here the population consists mainly of Athapaskan forest Indians who, except in becoming Christian, have resisted Europeanization much more successfully than either Eskimos or Aleuts, and far more successfully than the natives of the Panhandle.

According to Dr. Fellows the per hundred thousand rate is white 98, native 3; in percentage it is white 8.4, native 0.1; in actual number of cancer deaths the Fourth Judicial has white 27 and native 1.

The medical missionary theorists, those who favor the Tanchou-Le Conte principle, will think that the percentage table (the middle division of Dr. Fellows' Table 2) confirms their belief in most satisfactory fashion. In percentages of all deaths during the five years 1926-30, the cancer rate drops from the highest to the lowest of the districts on the scale as 7.8 to 2.8; 6.0 to 1.4; 10.8 to 0.8; and 8.4 to 0.1.

Dr. L. A. White practiced in Alaska and rarely found hypertensive, arteriosclerotic, diabetes, cancer, strokes, or coronary heart disease among the natives between 1934-1948.

Dr. L. A. White of 642 Eugene Medical Center, Eugene, Oregon, wrote me on February 21, 1958:

“... It has been almost 17 years since I practiced in Alaska. I was at Unalaska [Aleutian Islands] 1934-48, having previously spent 17 months at Metlakatla [Alaska Panhandle], then several months in '39 at Klawock [Panhandle]; finally one and a half years at Bethel [Lower Kuskokwim]. My work led me to these conclusions: (1) hypertensive and arteriosclerotic diseases were practically nonexistent among the native peoples; (2) diabetes was extremely rare; (3) malignant disease was extremely rare — in fact, I had only one proven case (Bethel, 1940). I saw no strokes nor coronary heart disease ...”

Very little exact information is available regarding the occurrence of arteriosclerosis in Eskimos. None of the 16 Eskimos analyzed here showed any evidence of arteriosclerosis by clinical or roentgenological examination, and cardiovascular disease was extremely rare among the large number of Eskimo patients examined by the author during a two-year period in Alaska.

4. Discussion. 

Since hypertension in man has been stated to be typically associated with increased incidence and severity of atherosclerosis (Katz and Stamler, 1953), it would be of interest to compare the incidence of hypertension in Eskimos with that of Whites although the interrelationship between hypertension and atherosclerosis is by no means clear. In a survey of 104 Alaskan Eskimos the author found that both the systolic and diastolic blood pressures were lower in Eskimos than in Whites of corresponding age. Eighty per cent of the recorded systolic blood pressures were below 116 mm Hg. and no systolic blood pressure higher than 162 mm was ever recorded in our "normal" Eskimo subjects. In a series of 117 Eskimo patients, only one of the patients had systolic blood pressure above 145 mm (a 60-year old woman having a blood pressure of 200/80 mm) (Rodahl, 1954). It may be noted in this connection that Alexander (1949) found hypertension to be practically non-existent among Aleuts, and his electrocardiographic and clinical examination of 296 Aleuts, including 23 above the age of 60, revealed almost no cardiovascular disease. 

Gotman et al. (1950) have found that some hypertensives show elevated plasma concentrations of Sf 10-20 lipoproteins even if the blood cholesterol concentration is normal, although these changes in the "giant molecule" levels are not correlated with the degree of hypertension. 

Very little is known regarding the plasma lipids in Eskimos, and the plasma lipid studies in Eskimos so far reported have yielded inconsistent data. This may not be surprising when considering the wide range of conditions, dietary and otherwise, encountered in the different groups of Eskimos. Corcoran and Rabinowitch (1937) who studied two groups of Canadian Eskimos, one group subsisting on a meat diet and one group subsisting on a mixed diet, found in both groups lower concentrations of plasma lipids and of cholesterol than the normal values for Whites, and the meat group had slightly higher plasma lipid levels than the group on a mixed diet. In this connection it may be noted that serum cholesterol in Whites is decreased in severe caloric undernutrition (Keys, 1953-b). Periods of semi-starvation may occur among the Eskimos, which thus may affect the blood lipid levels. Sinclair et al. ( 1949) have reported plasma lipid findings in the Canadian Eskimos that are similar to the figures considered normal in Americans. Wilber and Levine (1950) found moderately elevated plasma lipid levels of Alaskan Eskimos. It may also be noted that Alexander (1949) found mean plasma cholesterol levels of 176-197 mg/l 00 ml in two groups of Aleuts. 

In view of the small number of Eskimos examined in the present study no definite conclusion can be drawn from this limited material. These preliminary investigations indicate, however, that while some Eskimos, such as the Nunamiuts, may have very high cholesterol intakes, the average figures for dietary cholesterol and fat for the four Eskimo groups examined are comparable to those of the average American man; their blood cholesterol levels are the same, while the Sf 12-20 lipoproteins (Gofman fraction) were lower in concentration than Whites of corresponding age. If it were convincingly demonstrated that the Eskimos in reality have a lower incidence of cardiovascular disease than Whites, it would appear that these findings support Gofman's postulates that the high concentration of the cholesterol-bearing protein molecules are associated with atheroclerosis. 

It should be noted, however, that very little exact information is available regarding the occurrence of arteriosclerosis in Eskimos. None of the 16 Eskimos analyzed here showed any evidence of arteriosclerosis by clinical or roentgenological examination, and cardiovascular disease was extremely rare among the large number of Eskimo patients examined by the author during a two-year period in Alaska. Similarly, Dr. Paul Haggland, who has operated on a large number of Eskimos in Alaska during the last 15 years, has never seen arteriosclerosis or atherosclerosis in Eskimos (personal communications). He had the occasion to perform autopsy on one female and two male Eskimos, aged 60-65 years, and found no arteriosclerosis. Dr. Earl Albrecht, Territory Commissioner of Health, states that arteriosclerosis is rare in Eskimos, based on clinical evidence (personal communications). 

Bertelsen (1940) is, on the other hand, of the opinion that arteriosclerosis is fairly common in Greenland, particularly if one considers the average span of life for the Greenland Eskimos. Hoygaard (1941) writes with regard to the Angmagssalik Eskimos, Southeast Greenland, that "arteriosclerosis was frequently found even in persons below 40". 

Brown (1951) states with regard to the Southampton Island Eskimos and the Igloolik Eskimos: "We have found well-marked general arteriosclerosis and also coronary heart disease proved by electrocardiogram and, in one case, by post mortem. Some of the cases of coronary heart disease were in congestive failure." 

During our study of the patho-physiology of the Alaskan Eskimos from 1950 to 1952, x-rays were taken of the chest and extremities of 84 Eskimos, using a portable x-ray apparatus. All chest x-rays were taken at a distance of 180 cm; all x-rays of the limbs (left arm and left leg) were taken at a distance of 90 cm. Professor Johan Torgersen, Institute of Anatomy, Oslo University, has very kindly examined all these roentgenograms, with a particular reference to possible roentgenological evidence of arteriosclerosis and other cardiovascular abnormalities. He finds, as a typical feature of all roentgenograms examined, that the bone structure in the Eskimo is unusually massive with sharply defined, well-calcified bone lamellae. The muscle attachments are as a rule very large. The occurrence of arthritis deformans is no less frequent in these Eskimos than in Whites of similar age (:5 cases in 84 Eskimos, 51 males and 33 females, with an average age of 28 years). Four Eskimo subjects at Barter Island had cartilaginous exostoses on the tibia (fig. 2). 

From this material (see Table 5) it appears that the occurrence of roentgenological evidence of arteriosclerosis in these Eskimos is neither more nor less than what one would expect to find in Whites of similar age groups. Out of 9 Eskimos over 47 years of age, roentgenological evidence of atherosclerosis of the arch of the aorta was detected in 3 cases, 2 males and 1 female. Of the entire material one Eskimo showed calcium deposits in the arteries (see fig. 1). In one 60-year old Eskimo woman with a blood pressurc of 200/80, thcre was slight enlargemcnt of the left ventricle of the heart. It is thus evident that further studies are necessary in order to settle the question of arteriosclerosis in the Eskimo and the relation between dietary cholesterol, serum cholesterol levels and cardiovascular disease ill these people.

5. Summary and Conclusions. 

The cholesterol content of some common Eskimo foods has been determined and the serum cholesterol level as well as the serum concentration of Sf 12-20 lipoproteins in 16 healthy Alaskan Eskimos are reported. On the basis of these preliminary data it appears that some Eskimos have high cholesterol intakes compared with healthy American men, but that their blood cholesterol levels are the same. On the other hand, the Sf 12-20 lipoproteins in Eskimos are lower in concentration than in Whites of corresponding age. From the available evidence it appears that the incidence of cardiovascular disease among the Alaskan Eskimos may be lower than in whites. A more complete analysis of this problem is in progress.

Modern Eskimos face great threat of cancer, showing how civilization destroys their health.

Paper published 1989:

​

Abstract

The authors collected and analyzed cancer incidence data for Alaska Natives (Indians, Eskimos, and Aleuts) for the 15-year period 1969-83 by ethnic and linguistic groups. Compared with U.S. whites, observed-to-expected ratios are high in more than one ethnic group for cancer of the nasopharynx, salivary gland, liver, gallbladder, and cervix. Low ratios were found for cancer of the breast, uterus, bladder, and melanoma. In Alaska, Eskimos have the highest risk for cancer of the esophagus and liver and the lowest risk for breast and prostate cancer. Risk for multiple myeloma in Indian men in Alaska exceeds not only those of other Native groups in Alaska but that in U.S. whites as well. Despite the short period studied, increases in cancer incidence over time can be documented for lung cancer in Eskimo men and women combined, and for cervical cancer, especially in Indian women.