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Background. Guatemala lacks cancer prevention strategies and has low screening rates. Objective. To assess the history of chronic conditions, risk factors, and cancer screening uptake among three Indigenous populations of Southwestern Guatemala. Methods. We conducted a health needs assessment. Results. The assessment was completed by 247 adults. Median age was 40 years old (IR: 28–59). Most participants were female (94.3%), of Mayan descent (95.8%), and did not have a primary health care provider (84.2%). Most have never been screened for colorectal (men=100.0%; women=98.8%), prostate (75.0%), breast (90.9%), or cervical (76.9%) cancer, and all have severe tooth decay. However, most participants reported healthy behaviors including being physically active (women=59.7%; men=92.9%), being nonsmokers (women=99.6%; men=78.6%), and not consuming alcohol (women=82.3%; men=46.7%). Conclusions. Although most participants reported healthy behaviors, there is a remarkable lack of access to cancer screening. An increase in cancer incidence is expected unless cancer prevention efforts are undertaken.