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First Nations Cancer Burden

Key findings

  • First Nations peoples have a higher incidence of lung (females) and colorectal cancers, and a lower incidence of breast and prostate cancers.
  • Cancer mortality is higher in First Nations peoples as well, particularly for lung and colorectal cancers. Among First Nations peoples, 5-year observed survival was best for female breast and male prostate cancers; however, survival was still poorer than in other people in Ontario.
  • Cancer burden estimates are important to equip First Nations communities with information needed to set priorities and plan effective health programs to improve the health and well-being of their people.

Results

For technical information, see:

Female breast cancer

From 1991 to 2010, breast cancer was the most commonly diagnosed cancer among First Nations females, accounting for over 900 new cases. It was also the most commonly diagnosed cancer among other females in Ontario in the same 20-year period.

Although breast cancer was the second leading cause of cancer death in First Nations females and other females in Ontario, breast cancer mortality was lower in First Nations females than other females in Ontario. This may be because fewer First Nations women were being diagnosed with breast cancer.

There is a very good chance of surviving 5 years or longer following a breast cancer diagnosis. From 2001 to 2010, about 5 of every 7 First Nations females diagnosed with breast cancer (73%) survived 5 years or longer. A similar percentage of other Ontario women with breast cancer survived 5 years or longer during the same period.

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 1: Age-adjusted breast cancer incidence of First Nations females in Ontario compared with other females in Ontario, all ages, 1991 to 2010
      First Nations females Other females
    Females 70 81

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 2: Age-adjusted breast cancer incidence of First Nations females in Ontario compared with other females in Ontario, by year, all ages, 1991 to 2010
    Yeat Incidence for First Nations Trend for First Nations Incidence for Others Trend for Others
    1991 61.23 61.37 81.83 81.9
    1992 63.02 62.1 83.08 81.83
    1993 45.76 62.83 79.35 81.75
    1994 68.78 63.58 78.56 81.68
    1995 62.64 64.34 80.57 81.61
    1996 64.95 65.1 79.72 81.53
    1997 68.74 65.88 83.3 81.46
    1998 75.15 66.66 83.43 81.39
    1999 69.45 67.45 85.4 81.31
    2000 70.19 68.26 81.63 81.24
    2001 74.54 69.07 82.01 81.17
    2002 71.96 69.89 84.3 81.09
    2003 63.83 70.72 79.23 81.02
    2004 66.04 71.56 80.11 80.95
    2005 67.16 72.41 80.52 80.87
    2006 70.68 73.27 79.5 80.8
    2007 80.18 74.15 80.59 80.73
    2008 72.78 75.03 78.36 80.65
    2009 66.88 75.92 80.1 80.58
    2010 86.06 76.82 82.12 80.51

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Data Table 3: Age-adjusted breast cancer mortality of First Nations females in Ontario compared with other females in Ontario, all ages, 1991 to 2010
      First Nations females Other females
    Population 16 19

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 4: Age-adjusted 5-year breast cancer survival of First Nations females in Ontario compared with other females in Ontario, all ages, 1991 to 2010
      First Nations females Other females
    Population 73 77

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Colorectal cancer

    From 1991 to 2010, colorectal cancer was the second most commonly diagnosed cancer in First Nations peoples, with almost 1,000 new cases in this 20-year period. It was the fourth most common cancer diagnosed among all other people in Ontario.

    Colorectal cancer was also the second leading cause of cancer death in both First Nations peoples and all other people in Ontario. About half of people with colorectal cancer (50% for First Nations peoples and 54% for other people) survived for at least 5 years after their cancer diagnosis. Someone is more likely to survive for 5 years after being diagnosed with colorectal cancer if the cancer is caught at an earlier stage, when it is easier to treat.

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Figure 5: Age-adjusted colorectal cancer incidence of First Nations people in Ontario compared to other people in Ontario, all ages, 1991 to 2010
    Sex First Nations Others
    Males 56 41
    Females 38 28

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 6: Age-adjusted colorectal cancer incidence of First Nations females in Ontario compared with other females in Ontario, by year, all ages, 1991 to 2010
    Year First Nations Observed Incidence First Nations Incidence Trend Others Observed Incidence Others Incidence Trend
    1991 31.93 37.32 31.19 29.85
    1992 39.93 37.45 28.41 29.71
    1993 36.65 37.58 29.11 29.57
    1994 46.17 37.72 29.62 29.43
    1995 39.69 37.85 29.27 29.3
    1996 25.24 37.98 27.47 29.16
    1997 46.45 38.12 26.74 29.02
    1998 52.35 38.25 30.01 28.89
    1999 24.45 38.39 29.99 28.75
    2000 41.57 38.52 29.43 28.62
    2001 30.57 38.66 29.61 28.49
    2002 41.08 38.8 28.68 28.35
    2003 32.02 38.94 28.48 28.22
    2004 36.28 39.07 28.4 28.09
    2005 35.33 39.21 27.84 27.96
    2006 34.15 39.35 27.33 27.83
    2007 38.85 39.49 28.12 27.7
    2008 42.98 39.63 27.61 27.57
    2009 39.04 39.77 27.48 27.44
    2010 46.46 39.91 26.22 27.31

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Data Table 7: Age-adjusted colorectal cancer incidence of First Nations males in Ontario compared with other males in Ontario, by year, all ages, 1991 to 2010
    year First Nations Observed Incidence First Nations Incidence Trend Others Observed Incidence Others Incidence Trend
    1991 28.3 55.7 42.2 42.2
    1992 84.3 55.9 43.3 42.1
    1993 52.0 56.1 41.6 42.1
    1994 51.9 56.3 42.8 42.1
    1995 36.0 56.5 40.7 42.0
    1996 39.6 56.7 41.1 42.0
    1997 80.9 57.0 40.7 42.0
    1998 51.1 57.2 41.3 42.0
    1999 64.1 57.4 42.2 41.9
    2000 49.8 57.6 44.0 41.9
    2001 80.9 57.8 43.5 41.9
    2002 52.4 58.1 42.1 41.8
    2003 59.3 58.3 40.0 41.8
    2004 48.7 58.5 42.0 41.8
    2005 46.0 58.7 41.5 41.7
    2006 43.5 59.0 41.8 41.7
    2007 73.7 59.2 40.8 41.7
    2008 55.0 59.4 42.1 41.7
    2009 52.3 59.6 39.5 39.1
    2010 69.0 59.9 36.5 36.7

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Data Table 8: Age-adjusted colorectal cancer mortality of First Nations peoples in Ontario compared with other people in Ontario, all ages, 1991 to 2010
      First Nations Others
    Males 24 18
    Females 14 12

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 9: Age-adjusted 5-year colorectal cancer survival of First Nations peoples in Ontario compared with other people in Ontario, ages 15 to 74 years, 1991 to 2010
    sex First Nations Others
    Males 47 52
    Females 52 57

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Lung cancer

    From 1991 to 2010, lung cancer was the most commonly diagnosed cancer in First Nations peoples, accounting for over 1,000 new cases. For other people in Ontario, lung cancer was the third most common cancer diagnosed in this period.

    Lung cancer was also the leading cause of cancer death in First Nations peoples and other people in Ontario. About 1 in 7 (14%) of First Nations peoples with lung cancer survived for at least 5 years after their cancer diagnosis, compared with 1 in 6 (17%) of other people in Ontario.

    Five-year survival following a lung cancer diagnosis is poor for First Nations peoples and other people in Ontario because most lung cancers are found at a late stage, when they are hard to treat.

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 10: Age-adjusted lung cancer incidence of First Nations peoples in Ontario compared with other people in Ontario, all ages, 1991 to 2010
    sex First Nations Others
    Males 57 48
    Females 46 31

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 11: Age-adjusted lung cancer incidence of First Nations females in Ontario compared with other females in Ontario, by year, all ages, 1991 to 2010
    year First Nations Observed Incidence First Nations Incidence Trend Others Observed Incidence Others Incidence Trend
    1991 33.17 34.16 29.13 28.93
    1992 28.34 35.07 29.89 29.28
    1993 35.67 36.01 29.31 29.64
    1994 28.12 36.97 29.46 30
    1995 36.61 37.95 30.26 30.37
    1996 45.51 38.96 30.49 30.74
    1997 42.56 40 30.83 31.12
    1998 37.28 41.07 32.24 31.5
    1999 50.32 42.17 31.56 31.88
    2000 39.75 43.29 32.34 31.8
    2001 37.63 44.45 31.81 31.73
    2002 58.67 45.63 31.16 31.65
    2003 39.56 46.85 30.52 31.58
    2004 60.91 48.1 31.57 31.5
    2005 49.78 49.38 32.57 31.42
    2006 31.87 50.7 31.41 31.35
    2007 60.39 52.05 31.47 31.27
    2008 42.48 53.44 31.33 31.2
    2009 58.67 54.87 31.15 31.12
    2010 54.61 56.33 30.55 31.05

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Data Table 12: Age-adjusted lung cancer incidence of First Nations males in Ontario compared with other males in Ontario, by year, all ages, 1991 to 2010
    year First Nations Observed Incidence First Nations Incidence Trend Others Observed Incidence Others Incidence Trend
    1991 56.5 74.8 61.0 60.3
    1992 51.4 73.1 60.1 58.9
    1993 94.2 71.4 58.4 57.5
    1994 72.0 69.8 55.3 56.2
    1995 49.0 68.2 53.5 54.9
    1996 88.0 66.6 53.7 53.6
    1997 81.8 65.1 51.1 52.4
    1998 53.0 63.6 51.2 51.1
    1999 52.1 62.2 50.0 49.9
    2000 69.9 60.8 49.5 48.8
    2001 62.7 59.4 48.7 47.6
    2002 43.3 58.0 46.1 46.5
    2003 34.9 56.7 44.3 45.4
    2004 39.4 55.4 43.5 44.4
    2005 71.4 54.1 44.3 43.4
    2006 61.5 52.9 43.3 42.3
    2007 58.1 51.7 40.6 41.4
    2008 48.4 50.5 39.2 40.4
    2009 44.3 49.3 39.5 39.4
    2010 46.3 48.2 39.7 38.5

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Data Table 13: Age-adjusted lung cancer mortality of First Nations peoples in Ontario compared with other people in Ontario, all ages, 1991 to 2010
        First Nations Others
    Males 44 39
    Females 33 23

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 14: Age-adjusted 5-year lung cancer survival of First Nations peoples in Ontario compared with other people in Ontario, ages 15 to 74 years, 1991 to 2010
    sex First Nations Others
    Males 15 10
    Females 20 19

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Prostate cancer

    From 1991 to 2010, prostate cancer was the most commonly diagnosed cancer for First Nations males and other males in Ontario. There were 636 cases of prostate cancer diagnosed in First Nations males during this period. Prostate cancer commonly occurs in older men.

    Prostate cancer was the third leading cause of cancer death, with most deaths occurring in men over age 80 because this cancer normally grows quite slowly. About 3 in 4 (74%) of First Nations males and 4 in 5 (82%) of other males in Ontario with prostate cancer survived for at least 5 years after being diagnosed with cancer.

    Survival rates after a prostate cancer diagnosis are good because prostate cancer is often found early, before it has grown or spread to other parts of the body, and when effective treatments are available.

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 15: Age-adjusted prostate cancer incidence of First Nations males in Ontario compared with other males in Ontario, all ages, 1991 to 2010
      First Nations males Other males
    Population 73 91

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 16: Age-adjusted prostate cancer incidence of First Nations males in Ontario compared with other males in Ontario, by year, all ages, 1991 to 2010
    year First Nations Observed Incidence First Nations Incidence Trend Others Observed Incidence Others Incidence Trend
    1991 66.2 74.5 70.7 75.3
    1992 83.5 74.4 79.5 77.0
    1993 80.6 74.4 85.6 78.6
    1994 85.3 74.3 83.4 80.3
    1995 82.4 74.2 74.3 82.1
    1996 55.9 74.2 79.1 83.8
    1997 52.7 74.1 86.9 85.7
    1998 56.4 74.0 86.3 87.5
    1999 85.8 74.0 87.1 89.4
    2000 71.8 73.9 92.9 91.3
    2001 71.8 73.9 102.6 93.3
    2002 91.7 73.8 96.1 95.3
    2003 74.9 73.7 91.1 97.4
    2004 49.6 73.7 97.8 99.5
    2005 63.6 73.6 101.4 101.7
    2006 85.1 73.5 103.8 103.9
    2007 78.6 73.5 103.9 99.8
    2008 92.7 73.4 93.0 95.9
    2009 55.8 73.4 92.1 92.1
    2010 67.7 73.3 88.9 88.5

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Note: Values displayed are trend values; for observed estimates, please see corresponding data table.

    Data Table 17: Age-adjusted prostate cancer mortality of First Nations males in Ontario compared with other males in Ontario, all ages, 1991 to 2010
      First Nations males Other males
    Population 16 14

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Data Table 18: Age-adjusted prostate cancer mortality of First Nations males in Ontario compared with other males in Ontario, ages 15 to 74 years, 1991 to 2010
      First Nations males Other males
    Population 74 82

    Report date: November 2018

    Data source: Indian Registry System and Ontario Cancer Registry

    Prepared by: Indigenous Cancer Care Unit, Cancer Care Ontario

    Opportunities

    • Given the high cancer burden in First Nations peoples, efforts to reduce the number of risk factors through culturally tailored and community-led cancer prevention programs will be necessary.
    • Better cancer screening access, education and awareness are needed to improve participation and follow-up.
    • More data is needed to understand why cancer rates differ between First Nations peoples and other people in Ontario.

    For more information