Published September 22, 2017
COAST SALISH TERRITORY/VANCOUVER — The first study ever to compare the development and survival from cancer between First Nations people and non-First Nations people in British Columbia shows an overall lower incidence of the disease for First Nations people but also indicates lower survival rates for most cancers.
The study was conducted jointly by the BC Cancer Agency and First Nations Health Authority, and published in the journal Cancer Causes & Control. The 1993 to 2010 data set includes “Status Indian” peoples only and is not inclusive of all First Nations, Métis or Inuit peoples in BC.
The study shows both First Nations men and women experience a higher incidence of colorectal cancer, with a 22 per cent higher age-standardized incidence rate for women and 39 per cent for men. There also appears to be a trend towards increasing incidence for both sexes. More research is needed to understand the specific reasons for this elevated and increasing rate of colorectal cancer among BC First Nations.
A 92 per cent higher incidence rate of cervical cancer was observed among First Nations women. This may indicate that access to geographically available and/or culturally safe cervical cancer screening services may be a continuing barrier for First Nation women.
Incidence rates of almost all other cancers were generally similar or lower in First Nations populations compared to non-First Nation populations. Trends in incidence rates over time were also similar, with the exception of lung cancer, which is rising at a rate among First Nations that may soon overtake declining rates in non-First Nations.
First Nations people are also less likely to survive a cancer diagnosis compared to non-First Nations people. Overall, poorer survival was seen in the First Nation population in 10 of the 15 cancer types examined in women and 10 of the 12 cancer sites examined in men.
Lower survival rates could be influenced by a number of factors including challenges in access to high quality, timely, appropriate and effective cancer treatment, especially in rural and remote areas. Lower diagnosis may be impacted by limited access to screening programs. For many First Nations peoples, their cancer journey is negatively impacted through the experience of racism in health and social support settings.
Culturally safe health and social services reduce barriers to accessing care and detecting cancer early. First Nations people are more likely to access care that is appropriate to their wellness beliefs, goals and needs.
The findings in this study suggest a complex basis for these disparities in cancer incidence and survival, and further studies along the entire spectrum of cancer care—from wellness and prevention, to screening, diagnosis and treatment—are required.