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Cancer incidence among First Nations adults in Canada: follow-up of the 1991 Census Mortality Cohort (1992–2009)

  • Quantitative Research
  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Objectives

Estimate site-specific cancer incidence rates for a wide range of cancers in First Nations adults in Canada, and compare these with rates in non-Aboriginal adults.

Methods

Responses from persons aged 25 and older to the 1991 Long Form Census were linked to national mortality and cancer databases. First Nations- and non-Aboriginal-specific incidence rates were age-standardized to the world standard population. The sex- and site-specific relative risks (RR) of cancer in First Nations compared to those in non-Aboriginal adults were estimated with Poisson regression. Results were stratified by residence on-reserve (all cancers combined) and region of Canada (four most common cancer sites).

Results

Compared to non-Aboriginal adults, First Nations had higher incidence of colon and rectum, kidney, cervix, and liver cancers and lower incidence of prostate, breast, bladder, uterus, ovary, and brain cancers, as well as non-Hodgkin lymphoma, leukemia, and melanoma. First Nations women additionally had higher incidence of stomach, gallbladder, and laryngeal cancers and lower incidence of thyroid cancers compared to non-Aboriginal women. The higher relative incidence of stomach and gallbladder cancers was observed only among First Nations adults who reported living on-reserve. Incidence of lung cancer was similar for First Nations and non-Aboriginal adults nationally, though variation by region of Canada was observed.

Conclusion

First Nations people in Canada have disproportionately high rates of certain cancers, providing evidence to support public health policy and programming. More research is needed to identify factors contributing to the significantly lower incidence observed for various cancer types. Novel methods for studying disparities in cancer incidence among First Nations people are required to support ongoing cancer control planning and advocacy.

Résumé

Objectifs

Estimer les taux d’incidence de certains types précis de cancer chez les adultes des Premières nations au Canada, et les comparer aux taux des adultes non autochtones.

Méthodes

Les réponses de sujets de 25 ans et plus au questionnaire détaillé du recensement de 1991 ont été liées aux bases de données nationales sur la mortalité et le cancer. Les taux d’incidence propres aux Premières nations et aux personnes non autochtones ont été normalisés selon l’âge par rapport à la population mondiale standard. Les risques relatifs (RR) du cancer propres au type de cancer et au sexe du patient des Premières nations ont été estimés en les comparant à ceux des adultes non autochtones à l’aide de la régression de Poisson. Les résultats ont été stratifiés par résidence dans les réserves (tous cancers confondus) et par région du Canada (pour les quatre types de cancer les plus courants).

Résultats

Par comparaison avec les adultes non autochtones, les Premières nations présentaient des taux d’incidence plus élevés de cancers du côlon et du rectum, du rein, du col de l’utérus et du foie et des taux d’incidence plus faibles de cancers de la prostate, du sein, de la vessie, de l’utérus, de l’ovaire et du cerveau ainsi que de lymphome non hodgkinien, de leucémie et de mélanome. Les femmes des Premières nations présentaient aussi des taux d’incidence plus élevés de cancers de l’estomac, de la vésicule biliaire et du larynx et des taux d’incidence plus faibles de cancer de la thyroïde par rapport aux femmes non autochtones. L’incidence relative plus élevée de cancers de l’estomac et de la vésicule biliaire chez les adultes des Premières nations a été observée seulement chez les adultes qui ont déclaré vivre dans les réserves. L’incidence du cancer du poumon chez les Premières nations et chez les adultes non autochtones du pays était similaire, bien qu’un écart ait été observé dans certaines régions.

Conclusion

Les Premières nations du Canada présentent des taux démesurément élevés de certains cancers. Ces données permettront de prendre des décisions éclairées en matière de politiques et de programmes de santé publique. Des travaux de recherche supplémentaires devront être menés pour cerner certains facteurs contribuant à l’incidence significativement plus faible observée pour plusieurs types de cancers. De nouvelles méthodes doivent être élaborées pour étudier les disparités en matière d’incidence du cancer chez les membres des Premières nations afin de contribuer aux activités continues de planification et de promotion de la lutte contre le cancer.

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Funding

The work was supported by a Canadian Institutes of Health Research Open Operating Grant entitled “Cancer incidence and survival in First Nations and Métis adults in Canada: follow-up of the 1991 census cohort.”

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Author notes

  1. Maegan V. Mazereeuw

    Present address: Canadian Institute for Health Information, 4110 Yonge Street, Suite 300, Toronto, Ontario, M2P 2B7, Canada

Authors and Affiliations

  1. Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada

    Maegan V. Mazereeuw, Diana R. Withrow, E. Diane Nishri & Loraine D. Marrett

  2. Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada

    Michael Tjepkema

  3. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

    Loraine D. Marrett

Authors
  1. Maegan V. Mazereeuw
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  2. Diana R. Withrow
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  3. E. Diane Nishri
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  4. Michael Tjepkema
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  5. Loraine D. Marrett
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Corresponding author

Correspondence to Maegan V. Mazereeuw.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the research ethics board of the University of Toronto (protocol 29323). This manuscript was reviewed by staff of the Assembly of First Nations. Their feedback was incorporated in the final published version.

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Mazereeuw, M.V., Withrow, D.R., Diane Nishri, E. et al. Cancer incidence among First Nations adults in Canada: follow-up of the 1991 Census Mortality Cohort (1992–2009). Can J Public Health 109, 700–709 (2018). https://doi.org/10.17269/s41997-018-0091-0

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  • DOI: https://doi.org/10.17269/s41997-018-0091-0

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