Unique study compares cancer incidence and survival between Indigenous and non-Indigenous people in BC

The first study to compare the development of and survival from cancer between Indigenous and non-Indigenous people in British Columbia, conducted jointly by the BC Cancer Agency and First Nations Health Authority, shows a lower incidence of the disease for Indigenous people overall but also lower survival rates for most cancers. (The 1993 to 2010 data set includes only Status Indian peoples and not all First Nations, Métis, or Inuit peoples in BC.)

The study affirms the need for a system-wide response to improve cancer diagnosis and care for Indigenous people in BC, which is why the First Nations Health Authority, BC Cancer Agency, BC Association of Aboriginal Friendship Centres, and Métis Nation are working in partnership to complete an Indigenous cancer strategy to be released later this fall. They’re also engaging extensively with cancer survivors and their families and communities.

Both Indigenous men and women experience a higher incidence of colorectal cancer, with a 22% higher age-standardized incidence rate for women and 39% higher rate for men. The incidence for both sexes appears to be increasing, and more research is needed to understand the specific reasons why.

A 92% higher incidence rate of cervical cancer was observed among Indigenous women, which may indicate barriers to accessing local and/or culturally safe cervical cancer–screening services.

Incidence rates of almost all other cancers were generally similar or lower in Indigenous populations. Trends in incidence rates over time were also similar, with the exception of lung cancer, which is rising at a rate among Indigenous people that may soon overtake declining rates in non-Indigenous people.

Indigenous people are also less likely to survive a cancer diagnosis. Overall, poorer survival was seen in the Indigenous population in 10 of the 15 cancer types examined in women and 10 of the 12 cancer types examined in men.

Lower survival rates could be due to a lack of access to high-quality, timely, appropriate, and effective cancer treatment, especially in rural and remote areas. Limited access to screening programs may also lead to a lower rate of diagnosis. And many Indigenous people experience racism in health and social support settings, which can negatively impact the cancer journey.

Culturally safe health and social services means increased access to care and detecting cancer early. You’re more likely to access care that is appropriate to your wellness beliefs, goals, and needs.

The study suggests 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.

The study, “Cancer in First Nations people living in British Columbia, Canada: An analysis of incidence and survival from 1993 to 2010,” was published in Cancer Causes and Control (https://link.springer.com/article/10.1007/s10552-017-0950-7).