What is the role of diet in the development of cancer in American Indian and Alaska Native populations?

Background. The associations between diet and cancer in American Indian and Alaska Native (AIAN) populations are not well understood. Methods. I review current knowledge of the associations between diet and cancer. Results. Studies of diet and cancer are inconsistent. Underlying characteristics of populations could contribute to observed differences. Dietary patterns and energy balance may importantly relate to cancer in AIAN populations. Conclusion. Given the differences in cancer incidence and mortality rates in AIAN populations, it is reasonable that diet and lifestyle patterns could contribute to these differences, although we can only speculate as to specific dietary factors in cancer etiology.