Cancer in First Nations people living in British Columbia, Canada: an analysis of incidence and survival from 1993 to 2010
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.
KeywordsCancer Incidence Survival First Nations Canada British Columbia
- 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. http://www.ncbi.nlm.nih.gov/books/NBK215751/
- 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
- 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.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.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.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 http://publications.gc.ca/collections/collection_2014/sc-hc/H34-193-3-2014-eng.pdf
- 14.First Nations Health Authority (2012). Healthy children, healthy families, healthy communities: BC provincial results 2008–2010 First Nations Regional Health SurveyGoogle Scholar
- 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
- 18.Physicians for a smoke-free Canada. Aboriginal smokers (2013) http://www.smoke-free.ca/factsheets/pdf/cchs/aboriginal.pdf
- 19.Canadian Cancer Society’s Advisory Committee on Cancer Statistics Canadian Cancer Society (2015) Toronto, ONGoogle Scholar
- 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. http://www.statcan.gc.ca/pub/89-503-x/2010001/article/11442-eng.pdf
- 22.Borugian MJ, Spinelli JJ, Abanto Z, Xu CL, Wilkins R (2011) Breast cancer incidence and neighbourhood income. Health Rep 22(2):7–13. http://www.ncbi.nlm.nih.gov/pubmed/21848127
- 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. https://www.aadnc-aandc.gc.ca/eng/1378411773537/1378411859280
- 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.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