The burden of cancer risk in Canada’s indigenous population: a comparative study of known risks in a Canadian region

Abstract

Background

Canadian First Nations, the largest of the Aboriginal groups in Canada, have had lower cancer incidence and mortality rates than non-Aboriginal populations in the past. This pattern is changing with increased life expectancy, a growing population, and a poor social environment that influences risk behaviors, metabolic conditions, and disparities in screening uptake. These factors alone do not fully explain differences in cancer risk between populations, as genetic susceptibility and environmental factors also have significant influence. However, genetics and environment are difficult to modify. This study compared modifiable behavioral risk factors and metabolic-associated conditions for men and women, and cancer screening practices of women, between First Nations living on-reserve and a non-First Nations Manitoba rural population (Canada).

Methods

The study used data from the Canadian Community Health Survey and the Manitoba First Nations Regional Longitudinal Health Survey to examine smoking, binge drinking, metabolic conditions, physical activity, fruit/vegetable consumption, and cancer-screening practices.

Results

First Nations on-reserve had significantly higher rates of smoking (P < 0.001), binge drinking (P < 0.001), obesity (P < 0.001) and diabetes (P < 0.001), and less leisure-time physical activity (P = 0.029), and consumption of fruits and vegetables (P < 0.001). Sex differences were also apparent. In addition, First Nations women reported significantly less uptake of mammography screening (P < 0.001) but similar rates for cervical cancer screening.

Conclusions

Based on the findings of this retrospective study, the future cancer burden is expected to be high in the First Nations on-reserve population. Interventions, utilizing existing and new health and social authorities, and long-term institutional partnerships, are required to combat cancer risk disparities, while governments address economic disparities.

Keywords:

• indigenous population
• cancer risk
• health behaviors
• metabolic diseases
• cancer screening

Acknowledgments

This research was supported by the Canadian Institutes of Health Research (#AQC-83508) Dr Brenda Elias is supported by a CIHR New Investigator award and Dr Patricia Martens is supported by a CIHR/PHAC Applied Public Health Chair.

The Manitoba First Nations Regional Longitudinal Health Survey was a joint initiative of the Assembly of Manitoba Chiefs and the Manitoba First Nations Centre for Aboriginal Health Research (Dr Brenda Elias). The results and conclusions are those of the authors and no official endorsement by the Assembly of Manitoba Chiefs is intended or should be inferred.

Disclosure

The authors report no conflicts of interest in this work.