Cancer incidence, stage at diagnosis and outcomes among Manitoba First Nations people living on and off reserve: a retrospective population-based analysis.

Journal

CMAJ open
ISSN: 2291-0026
Titre abrégé: CMAJ Open
Pays: Canada
ID NLM: 101620603

Informations de publication

Date de publication:
Historique:
entrez: 20 12 2019
pubmed: 20 12 2019
medline: 20 12 2019
Statut: epublish

Résumé

Substantial cancer-related disparities exist between First Nations and non-Indigenous Canadians. The objectives of this study were to compare cancer incidence, stage at diagnosis and mortality outcomes between Status First Nations people living on reserve and off reserve in Manitoba. We conducted a retrospective analysis of population-level administrative health databases in Manitoba. Cancers diagnosed between Apr. 1, 2004, and Mar. 31, 2011, were linked with the Indian Registry System and 5 provincial databases. We compared differences in baseline characteristics, cancer incidence, site and stage at diagnosis between Status First Nations patients living on and off reserve. Linear regression models examined trends in annual cancer incidence. Cox proportional hazard regression models examined mortality. There were 1524 newly diagnosed cancers among Status First Nations people in Manitoba between Apr. 1, 2004, and Mar. 31, 2011. First Nations people living on reserve were significantly older than those living off reserve ( The lower proportion of on-reserve patients diagnosed with cancer at stage I is concerning, as it suggests less access to screening services or delays in diagnosis. Further research is needed to understand patterns in diagnosis and differences in cancer site and overall cancer incidence between First Nations people living on and off reserve.

Sections du résumé

BACKGROUND BACKGROUND
Substantial cancer-related disparities exist between First Nations and non-Indigenous Canadians. The objectives of this study were to compare cancer incidence, stage at diagnosis and mortality outcomes between Status First Nations people living on reserve and off reserve in Manitoba.
METHODS METHODS
We conducted a retrospective analysis of population-level administrative health databases in Manitoba. Cancers diagnosed between Apr. 1, 2004, and Mar. 31, 2011, were linked with the Indian Registry System and 5 provincial databases. We compared differences in baseline characteristics, cancer incidence, site and stage at diagnosis between Status First Nations patients living on and off reserve. Linear regression models examined trends in annual cancer incidence. Cox proportional hazard regression models examined mortality.
RESULTS RESULTS
There were 1524 newly diagnosed cancers among Status First Nations people in Manitoba between Apr. 1, 2004, and Mar. 31, 2011. First Nations people living on reserve were significantly older than those living off reserve (
INTERPRETATION CONCLUSIONS
The lower proportion of on-reserve patients diagnosed with cancer at stage I is concerning, as it suggests less access to screening services or delays in diagnosis. Further research is needed to understand patterns in diagnosis and differences in cancer site and overall cancer incidence between First Nations people living on and off reserve.

Identifiants

DOI: 10.9778/cmajo.20190176 PMID: 31852681 PMC: PMC6934385
pubmed: 31852681
pii: 7/4/E754
doi: 10.9778/cmajo.20190176
pmc: PMC6934385
doi:

Types de publication

Journal Article

Langues

eng

Pagination

E754-E760

Informations de copyright

Copyright 2019, Joule Inc. or its licensors.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Tara C Horrill (TC)

College of Nursing (Horrill, Thompson, Schultz), Rady Faculty of Health Sciences, University of Manitoba; Rady Faculty of Health Sciences (Dhal, Cook), University of Manitoba, Winnipeg, Man.; University College of the North (Sanderson); Cree Nation Tribal Health Centre (Munro), The Pas, Man.; Interlake Reserves Tribal Council (Garson); Manitoba Centre for Health Policy (Fransoo), University of Manitoba; Indigenous Health Library (Linton), University of Manitoba, Winnipeg, Man. Tara.horrill@umanitoba.ca.

Lindsey Dahl (L)

College of Nursing (Horrill, Thompson, Schultz), Rady Faculty of Health Sciences, University of Manitoba; Rady Faculty of Health Sciences (Dhal, Cook), University of Manitoba, Winnipeg, Man.; University College of the North (Sanderson); Cree Nation Tribal Health Centre (Munro), The Pas, Man.; Interlake Reserves Tribal Council (Garson); Manitoba Centre for Health Policy (Fransoo), University of Manitoba; Indigenous Health Library (Linton), University of Manitoba, Winnipeg, Man.

Esther Sanderson (E)

College of Nursing (Horrill, Thompson, Schultz), Rady Faculty of Health Sciences, University of Manitoba; Rady Faculty of Health Sciences (Dhal, Cook), University of Manitoba, Winnipeg, Man.; University College of the North (Sanderson); Cree Nation Tribal Health Centre (Munro), The Pas, Man.; Interlake Reserves Tribal Council (Garson); Manitoba Centre for Health Policy (Fransoo), University of Manitoba; Indigenous Health Library (Linton), University of Manitoba, Winnipeg, Man.

Garry Munro (G)

College of Nursing (Horrill, Thompson, Schultz), Rady Faculty of Health Sciences, University of Manitoba; Rady Faculty of Health Sciences (Dhal, Cook), University of Manitoba, Winnipeg, Man.; University College of the North (Sanderson); Cree Nation Tribal Health Centre (Munro), The Pas, Man.; Interlake Reserves Tribal Council (Garson); Manitoba Centre for Health Policy (Fransoo), University of Manitoba; Indigenous Health Library (Linton), University of Manitoba, Winnipeg, Man.

Cindy Garson (C)

College of Nursing (Horrill, Thompson, Schultz), Rady Faculty of Health Sciences, University of Manitoba; Rady Faculty of Health Sciences (Dhal, Cook), University of Manitoba, Winnipeg, Man.; University College of the North (Sanderson); Cree Nation Tribal Health Centre (Munro), The Pas, Man.; Interlake Reserves Tribal Council (Garson); Manitoba Centre for Health Policy (Fransoo), University of Manitoba; Indigenous Health Library (Linton), University of Manitoba, Winnipeg, Man.

Randy Fransoo (R)

College of Nursing (Horrill, Thompson, Schultz), Rady Faculty of Health Sciences, University of Manitoba; Rady Faculty of Health Sciences (Dhal, Cook), University of Manitoba, Winnipeg, Man.; University College of the North (Sanderson); Cree Nation Tribal Health Centre (Munro), The Pas, Man.; Interlake Reserves Tribal Council (Garson); Manitoba Centre for Health Policy (Fransoo), University of Manitoba; Indigenous Health Library (Linton), University of Manitoba, Winnipeg, Man.

Genevieve Thompson (G)

College of Nursing (Horrill, Thompson, Schultz), Rady Faculty of Health Sciences, University of Manitoba; Rady Faculty of Health Sciences (Dhal, Cook), University of Manitoba, Winnipeg, Man.; University College of the North (Sanderson); Cree Nation Tribal Health Centre (Munro), The Pas, Man.; Interlake Reserves Tribal Council (Garson); Manitoba Centre for Health Policy (Fransoo), University of Manitoba; Indigenous Health Library (Linton), University of Manitoba, Winnipeg, Man.

Catherine Cook (C)

College of Nursing (Horrill, Thompson, Schultz), Rady Faculty of Health Sciences, University of Manitoba; Rady Faculty of Health Sciences (Dhal, Cook), University of Manitoba, Winnipeg, Man.; University College of the North (Sanderson); Cree Nation Tribal Health Centre (Munro), The Pas, Man.; Interlake Reserves Tribal Council (Garson); Manitoba Centre for Health Policy (Fransoo), University of Manitoba; Indigenous Health Library (Linton), University of Manitoba, Winnipeg, Man.

Janice Linton (J)

College of Nursing (Horrill, Thompson, Schultz), Rady Faculty of Health Sciences, University of Manitoba; Rady Faculty of Health Sciences (Dhal, Cook), University of Manitoba, Winnipeg, Man.; University College of the North (Sanderson); Cree Nation Tribal Health Centre (Munro), The Pas, Man.; Interlake Reserves Tribal Council (Garson); Manitoba Centre for Health Policy (Fransoo), University of Manitoba; Indigenous Health Library (Linton), University of Manitoba, Winnipeg, Man.

Annette S H Schultz (ASH)

College of Nursing (Horrill, Thompson, Schultz), Rady Faculty of Health Sciences, University of Manitoba; Rady Faculty of Health Sciences (Dhal, Cook), University of Manitoba, Winnipeg, Man.; University College of the North (Sanderson); Cree Nation Tribal Health Centre (Munro), The Pas, Man.; Interlake Reserves Tribal Council (Garson); Manitoba Centre for Health Policy (Fransoo), University of Manitoba; Indigenous Health Library (Linton), University of Manitoba, Winnipeg, Man.

Classifications MeSH