Study Finds Poorer Cancer Survival Among First Nation Adults in Canada

A new study published in Cancer Epidemiology, Biomarkers and Prevention has found that First Nations in Canada have significantly poorer 5-year survival from cancer than non-Aboriginals.

The study is the first nationwide effort to analyze cancer survival rates for First Nation cancer patients. The findings are consistent with those of provincial studies conducted by Cancer Care Ontario, and they reinforce the urgent need for interventions to improve health outcomes for First Nations and to develop data systems and infrastructure that will help us monitor progress.

Using 4 national administrative databases, study authors from Cancer Care Ontario, the Pediatric Oncology Group of Ontario and Statistics Canada estimated cancer survival in First Nations across Canada from 1992 to 2009 and compared it to survival among non-Aboriginal Canadians.

"The burden of cancer among First Nations, Inuit and Métis people has been understudied for decades, but there's a particular lack of information about survival," says Dr. Loraine Marrett, Senior Scientist, Cancer Care Ontario. "This study enhances our understanding of disparities across the country and will help measure our progress in narrowing the survival gap."

Key study findings:

• First Nations diagnosed with cancers of the colon and rectum, lung and bronchus, breast, prostate, oral cavity and pharynx, cervix, ovary or with non-Hodgkin lymphoma or leukemia all had significantly poorer 5-year survival than non-Aboriginals. Disparities could not be explained by differences between First Nations and non-Aboriginals in income or where they live (e.g., an urban or rural area).
• The largest absolute differences in survival rates between First Nations and non-Aboriginals were for cervical and ovarian cancers, where 5-year survival was at least 20% higher among non-Aboriginals.
• The largest relative differences in survival were for First Nations with prostate and breast cancers, the 2 most common cancers among men and women respectively.

The disparities identified in this study are likely the result of many factors. There has been little study of the reasons for disparities in survival in Canada however, evidence from indigenous populations in other countries suggest that screening, stage at diagnosis, patients' health at the time of diagnosis and treatment all contribute to differences in cancer survival.

"A number of factors need to be addressed to reduce the burden of cancer and improve survival rates among First Nations, including prevention and screening uptake," says Alethea Kewayosh, Director, Aboriginal Cancer Control Unit, Cancer Care Ontario. "More research is needed to determine the exact causes of these disparities and to help inform culturally appropriate health interventions."

The study was supported by a Canadian Institutes for Health Research Open Operating Grant entitled "Cancer incidence and survival in First Nations and Metis adults in Canada: follow-up of the 1991 census cohort." It is also aligned with Cancer Care Ontario's Aboriginal Cancer Strategy III, which highlights research and surveillance, prevention and education as key priorities.

View a full copy of the study.

Related Links

• Visit mycanceriq.ca today to determine your personal cancer risk.
• To contact an Aboriginal Patient Navigator who can help First Nations and other Aboriginal cancer patients and their families, please visit Cancer Care Ontario's website.