Cancer Causes & Control

, Volume 28, Issue 10, pp 1105–1116 | Cite as

Cancer in First Nations people living in British Columbia, Canada: an analysis of incidence and survival from 1993 to 2010

  • Colleen E. McGahan
  • Kevin Linn
  • Preston Guno
  • Harmony Johnson
  • Andrew J. Coldman
  • John J. Spinelli
  • Nadine R. CaronEmail author
Original paper



For First Nations (FN) peoples living in British Columbia (BC), little is known regarding cancer in the population. The aim of this study was to explore cancer incidence and survival in the FN population of BC and compare it to the non-FN population.


All new cancers diagnosed from 1993 to 2010 were linked to the First Nations Client File (FNCF). Age-standardized incidence rates (ASIR) and rate ratios, and 1- and 5-year cause-specific survival estimates and hazard ratios were calculated. Follow-up end date for survival was December 31, 2011 and follow-up time was censored at a maximum of 15 years.


ASIR of colorectal cancer (male SRR = 1.42, 95% CI 1.25–1.61; female SRR = 1.21, 95% CI 1.06–1.38) and cervical cancer (SRR = 1.84, 95% CI 1.45–2.33) were higher overall in FN residents in BC, compared to non-FN residents. Incidence rates of almost all other cancers were generally similar or lower in FN populations overall and by sex, age, and period categories, compared to non-FN residents. Trends in ASIR over time were similar except for lung (increasing for FN, decreasing for non-FN) and colorectal cancers (increasing for FN, decreasing for non-FN). Conversely, survival rates were generally lower for FN, with differences evident for some cancer sites at 1 year following diagnosis.


FN people living in BC face unique cancer issues compared to non-FN people. Higher incidence and lower survival associated with certain cancer types require further research to look into the likely multifaceted basis for these findings.


Cancer Incidence Survival First Nations Canada British Columbia 



Eric Cai, Jeremy Hamm and Kimberly DeVries from the BC Cancer Agency, Dr. Evan Adams, and Miranda Kelly from the First Nations Health Authority and Dr. Shannon Waters from Health Canada.


  1. 1.
    Moore SP, Antoni S, Colquhoun A, Healy B, Ellison-Loschmann L, Potter JD, Garvey F (2015) Cancer incidence in indigenous people in Australia, New Zealand, Canada, and the USA: a comparative population-based study. Lancet Oncol 16(15):1483–1492CrossRefPubMedGoogle Scholar
  2. 2.
    National Research Council (2004) Eliminating health disparities: measurement and data needs. Panel on DHHS collection of race and ethnicity data. In: Ploeg MV, Perrin E (eds) Committee on National Statistics, Division of Behavioral and Social Sciences and Education. The National Academies Press, Washington, DC.
  3. 3.
    Elias B et al (2011) The burden of cancer risk in Canada’s indigenous population: a comparative study of known risks in a Canadian region. Int J Gen Med 4:699–709CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Kelly MD (2011) Toward a new era of policy: health care service delivery to First Nations. Int Indig Policy J 2(1):1–14Google Scholar
  5. 5.
    Gallagher J, Mendez JK, Kehoe T (2015) The First Nations health authority: a transformation in healthcare for BC First Nations. Healthc Manag Forum 28(6):255–261CrossRefGoogle Scholar
  6. 6.
    Canadian Cancer Society’s Advisory Committee on Cancer Statistics (2017) Canadian Cancer Statistics 2017. Appendix II, Table A3. Toronto, ON: Canadian Cancer SocietyGoogle Scholar
  7. 7.
    Segi M (1966) Cancer mortality for selected sites in 24 countries (1950–57). Sendai, Japan: Department of Public Health, Tohoku University School of Medicine. In: Doll R, Payne P, Waterhouse J (eds) Cancer incidence in five continents: a technical report. Springer, Berlin (for UICC)Google Scholar
  8. 8.
    Boyle P, Parkin DM (1991) Statistical methods for registries. In: Jensen OM, Parkin DM, MacLennan R, et al (eds) Cancer registration: principles and methods. International Agency for Research on Cancer (IARC Scientific Publication no. 95) Lyon, pp 126–58Google Scholar
  9. 9.
    Vital statistics for Atlantic and western Canada (2014) A statistical profile of the health of First Nations in Canada 2003–2007. Cat.: H34-193/3-2014E-PDF ISBN: 978-1-100-24686-4 Pub.: 140128
  10. 10.
    Howlader N, Ries LAG, Mariotto AB, Reichman ME, Ruhl J, Cronin KA (2010) Improved estimates of cancer-specific survival rates from population-based data. J Natl Cancer Inst 102:1584–1598CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Marrett LD, Chaudhry M (2003) Cancer incidence and mortality in Ontario First Nations, 1968-1991 (Canada). Cancer Causes Control 14:259–268CrossRefPubMedGoogle Scholar
  12. 12.
    Decker KM, Kliewer EV, Demers AA, Fradette K, Biswanger N, Musto G, Turner D (2016) Cancer incidence, mortality, and stage at diagnosis in First Nations living in Manitoba. Curr Oncol 23(4):225–232. doi: 10.3747/co.23.2906 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Giovannucci E, Kana W (2006) Cancers of the colon and rectum. In: Schottenfeld D, Fraumeni JF Jr (eds) Cancer epidemiology and prevention, vol 42, 3rd edn. Oxford University Press, New York, pp 809–994CrossRefGoogle Scholar
  14. 14.
    First Nations Health Authority (2012). Healthy children, healthy families, healthy communities: BC provincial results 2008–2010 First Nations Regional Health SurveyGoogle Scholar
  15. 15.
    Hislop TG, Clarke HF, Deschamps M et al (1996) Cervical cytology screening. How can we improve rates among First Nations women in urban British Columbia? Can Fam Phys 42:1701–1708Google Scholar
  16. 16.
    Demers AA, Kliewer EV, Remes O, Onysko J, Dinner K, Wong T, Jayaraman GC (2012) Cervical cancer among Aboriginal women in Canada. Can Med Assoc J. doi: 10.1503/cmaj.110523 Commentary Google Scholar
  17. 17.
    Rahal AK, Badgett RG, Hoffman RM (2016) Screening coverage needed to reduce mortality from prostate cancer: a living systematic review. PLoS ONE 11(4):e0153417. doi: 10.1371/journal.pone.0153417 CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Physicians for a smoke-free Canada. Aboriginal smokers (2013)
  19. 19.
    Canadian Cancer Society’s Advisory Committee on Cancer Statistics Canadian Cancer Society (2015) Toronto, ONGoogle Scholar
  20. 20.
    Nishri ED, Sheppard AJ, Withrow DR, Marrett LD (2014) Cancer survival among First Nations people of Ontario, Canada (1968-2007). Int J Cancer 136:639–645PubMedGoogle Scholar
  21. 21.
    Statistics Canada (2011) Women in Canada: a gender-based statistical report—First Nations, Métis and Inuit Women. Catalogue No. 89-503-XISBN 978-1-100-17400-6.
  22. 22.
    Borugian MJ, Spinelli JJ, Abanto Z, Xu CL, Wilkins R (2011) Breast cancer incidence and neighbourhood income. Health Rep 22(2):7–13.
  23. 23.
    Pendakur R, Pendaku K (2013) Aboriginal income disparity in Canada. Government of Canada. Aboriginal affairs and northern development Canada. Catalogue No. R3-176/2013E-PDF.
  24. 24.
    Borkhoff CM, Saskin R, Rabeneck L, Baxter NN, Liu Y, Tinmouth J, Paszat LF (2013) Disparities in receipt of screening tests for cancer, diabetes and high cholesterol in Ontario, Canada: a population-based study using area-based methods. Quant Res Can J Public Health 104(4):e282–e290Google Scholar
  25. 25.
    Sheppard AJ, Chiarelli AM, Marrett LD, Mirea L, Nishri ED, Trudeau ME (2010) Detection of later stage breast cancer in first nations women in Ontario, Canada. Can J Publ Health 11:01Google Scholar
  26. 26.
    Withrow DR, Pole JD, Nishri ED, Tjepkema M, Marrett LD (2017) Cancer survival disparities between First Nation and non-aboriginal adults in Canada: follow-up of the 1991 census mortality cohort. Cancer Epidemiol Biomark Prev 26(1):145–151. doi: 10.1158/1055-9965.EPI-16-0706 CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Colleen E. McGahan
    • 1
  • Kevin Linn
    • 2
  • Preston Guno
    • 1
  • Harmony Johnson
    • 2
  • Andrew J. Coldman
    • 1
  • John J. Spinelli
    • 1
    • 3
  • Nadine R. Caron
    • 1
    • 3
    • 4
    Email author
  1. 1.British Columbia Cancer AgencyVancouverCanada
  2. 2.First Nations Health AuthorityVancouverCanada
  3. 3.University of British ColumbiaVancouverCanada
  4. 4.Prince GeorgeCanada

Personalised recommendations