Linda Burhansstipanov, MSPH, DrPH: A Path Forged in Purpose
Image from UNC Lineberger Cancer Network webinar materials, via UNC Lineberger Comprehensive Cancer Center/UNC Cancer Leadership Council (UNCLCN).
Building culturally grounded cancer research and prevention for Native communities
At just 24, Lugene Flores, an Oglala Lakota woman, received an abnormal Pap test result shortly after giving birth. Fear, shame, and uncertainty kept her from returning for follow-up care - a hesitation that stretched into more than a decade. By the time she sought medical attention, doctors found stage II uterine cancer, requiring a complete hysterectomy and the removal of both ovaries and fallopian tubes (1). A longer delay may have cost her life.
Lugene’s story is a stark reminder of the social, emotional, and medical barriers faced by many native women which cause diagnoses to occur at more advanced stages, make treatment more complex, and result in poorer outcomes. Cultural hesitation toward Western medicine, limited transportation and childcare, negative experiences with health providers, strained communication, and a lack of trust, remain powerful obstacles to seeking care (2).
Each January, health advocates across the country turn their attention to Cervical Health Awareness. This annual focus reveals an unavoidable truth: for many marginalized communities, cervical health is fraught with difficulty. Cultural bias and longstanding systemic gaps in care have created conditions that place certain populations in the United States at far greater risk – many Native communities among them.
Cervical cancer is caused almost exclusively by infection with high-risk human papillomavirus (HPV) (3). Before the introduction of the HPV vaccine in 2006, population-based studies estimated that approximately 27% of U.S. women had detectable HPV infection (4), with clinic and community-based studies showing comparable prevalence among American Indian and Alaska Native women, though rates varied by region and type of HPV (5). Since the introduction of the HPV vaccination, overall cervical cancer incidence in the United States has declined (6), but many Native communities continue to experience significantly higher rates. Studies show that cervical cancer incidence in Native communities nearly twice that of non-Hispanic White women and elevated mortality across most U.S. regions (7), demonstrating that these disparities are persistent and ongoing.
Few have understood these challenges more deeply than Linda Burhansstipanov, MSPH, DrPH, a Native public health advocate whose lifelong leadership, compassion, and relentless advocacy have helped save countless lives.
Burhansstipanov, of Western Cherokee descent, was raised amid profound adversity. Her father’s severe physical violence terrorized the family, creating a constant state of chaos and fear. Burhansstipanov’s mother, without means to support herself and her children, could not enact an escape. After high school, amid unrelenting chaos, violence, and terror, Burhansstipanov forged a path toward independence. With her mother’s urging, Burhansstipanov attended California State University, and dreamed of a life of freedom - one where she could support herself and make meaningful contributions (8). Choosing a career in the health sciences launched a lifelong journey, profoundly shaping the health and well-being of American Indian communities.
Working four jobs to support herself, Burhansstipanov continued to attend school until earning a DrPH. Although living away from her childhood home, the familial violence that characterized her early family life gave way to one marked by unexpected kindness and compassion. Burhansstipanov’s mother left her abusive husband, and soon after, married a kind, warm, compassionate, and loving man. For the first time Burhansstipanov would learn how to trust and feel comfortable around men, and as a result, she would later take his name. In a tragic turn of events, he passed away a short time later from kidney cancer, an experience that helped shape Burhansstipanov’s eventual focus on cancer research, education, and prevention, particularly within underserved communities (8).
Going on to become a tenured professor, Burhansstipanov worked at one of the first urban American Indian clinics in Compton, California. While there, alarmingly high rates of cervical cancer were being diagnosed among the young women attending the clinic. Realizing that no research existed to explain this disparity, she applied for and received an NIH grant, developing background surveys and intervention strategies tailored to the Native population experiencing this condition. Her work gained national attention, leading to her recruitment to create a Native American Cancer Research Program at the NIH’s National Cancer Institute in 1989, which has continued to improve culturally appropriate cancer research, prevention and control strategies among Native American communities (8).
Missing teaching and direct work with communities, she later moved to Denver to join the AMC Cancer Research Center and went on to found Native American Cancer Initiatives (NACI), an organization that provides guidance on Native American health, cultural issues, program development, evaluation, and the full continuum of cancer care-from outreach through end-of-life support for communities, patients, researchers, academic institutions, and health professionals (8).
Confronting the long-standing breakdowns in cancer screening, prevention, and vaccine delivery for Native populations, Burhansstipanov has devoted her career to building culturally grounded education and care systems that reduce fear, mistrust, and barriers—so Native communities can access and accept life-saving care, including cervical cancer prevention.
Her work demonstrates that culturally informed methodology is not peripheral to cancer research in Native communities, but foundational to its scientific validity and real-world impact. By embedding community knowledge, trust, and cultural context into study design, outreach, and care delivery, she showed that science itself is strengthened when it is built in partnership with the people it is meant to serve.
As she has so aptly stated:
“Programs are not necessarily evidence-based unless they are based on evidence from the community in which they will be applied; a program designed for and by one community will not necessarily translate to another community... Strategies that work for non-Native communities frequently lack the inherent characteristics that need to be included in Native programs. Also, interventions need to be informed by the community, and particularly by the guidance of elders. ‘We stand on the shoulders of our ancestors’ (10).”
In Her Own Words:
This video by Croakey Health Media, features Dr. Linda Burhansstipanov sharing her passion for the work she does, and why cultural trust is essential to cancer prevention.
Croakey Health Media (2024). “Work together to survive”: Linda Burhansstipanov, Native American Cancer Initiatives [Video]. YouTube.
References and for Further Reading:
1. Lugene Flores story: American Indian Cancer Foundation. (n.d.). Survivorship. https://americanindiancancer.org/survivorship/
2. Ramirez, A. (2020, January 16). American Indians twice as likely to develop cervical cancer. National Indian Council on Aging. https://www.nicoa.org/american-indians-twice-as-likely-to-develop-cervical-cancer/
3. Walboomers, J. M., et al. (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. Journal of Pathology, 189(1), 12–19.
4. Dunne, E. F., et al. (2007). Prevalence of HPV infection among females in the United States: Results from NHANES 2003–2004. JAMA, 297(8), 813–819.
5. Lee, C. J., et al. (2018). Prevalence of high-risk HPV types and abnormal cervical cytology among American Indian women in the Northern Plains. PMC Article. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386810/
6. Garland, S. M., Kjaer, S. K., Muñoz, N., Block, S. L., Brown, D. R., DiNubile, M. J., Lindsay, B. R., Kuter, B. J., Perez, G., Dominiak‑Felden, G., Saah, A. J., Drury, R., Das, R., & Velicer, C. (2016). Impact and effectiveness of the quadrivalent human papillomavirus vaccine: A systematic review of 10 years of real‑world experience. Clinical Infectious Diseases, 63(4), 519–527.
7. CDC. (2025). Cancer and American Indian and Alaska Native people. https://www.cdc.gov/cancer/health-equity/american-indian-alaska-native.html
8. Burhansstipanov, L. (2011). Linda Burhansstipanov, DrPH — Public Health Educator [Biography PDF]. SACNAS. https://webarchive.loc.gov/all/20110909094507/http://bio.sacnas.org/beta/pdf/lindaB.pdf
9. Hubbard, P. (2001, December 27). Myths can bar way to cancer treatment. Indian Country Today. https://ictnews.org/archive/myths-can-bar-way-to-cancer-treatment/
10. National Academies of Sciences, Engineering, and Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press. https://www.nationalacademies.org/read/18496/chapter/1