Modifiable Risk Factors for Cancer among Inuit in Ontario and Other Regions in Canada

Key findings:

Inuit have higher prevalence of various cancer risk factors, including higher cigarette smoking and obesity.
Studying information about the prevalence of cancer risk factors may be the best way to determine where to direct cancer prevention resources most effectively to reduce the future burden of cancer and other chronic diseases.

See Modifiable Risk Factors in Inuit Methodology for technical information.

Report date: April 2017
Data source: Aboriginal Peoples Survey, 2012 (Statistics Canada); Canadian Community Health Survey, 2012 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Indigenous Cancer Care Unit)
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Inuit population outside Inuit Nunangat (from the 2006 Census).
2. Lines on the bars represent 95% confidence intervals.
3. † indicates high sampling variability in data for Inuit in Ontario. Interpret with caution.

Report date: March 2018
Data source: Aboriginal Peoples Survey, 2012 (Statistics Canada); Canadian Community Health Survey, 2012 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Indigenous Cancer Care Unit)
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Inuit population outside Inuit Nunangat (from the 2006 Census.
2. Lines on the bars represent 95% confidence intervals.
3. † indicates high sampling variability in data for Inuit outside Nunangat. Interpret with caution.

Data source: Aboriginal Peoples Survey, 2012 (Statistics Canada); Canadian Community Health Survey, 2012 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Indigenous Cancer Care Unit)
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Inuit population outside Inuit Nunangat (from the 2006 Census).
2. Lines on the bars represent 95% confidence intervals.
3. † indicates high sampling variability for Inuit men in Ontario. Interpret with caution.
4. Overweight and obesity are defined by Body Mass Index (BMI) values.
5. Overweight: BMI 25 to 29.99. Obesity: BMI 30 or greater.

Data Table 1: Percentage of Inuit and non-Aboriginal adults (ages 20 and older) who smoked daily or occasionally, Ontario, 2012
	Inuit in Ontario	Inuit in Ontario	Inuit in Ontario	Non-Aboriginal in Ontario	Non-Aboriginal in Ontario	Non-Aboriginal in Ontario
Population	34.1	20.2	48.1	22.6	20.9	24.3

Report date: April 2017
Data source: Aboriginal Peoples Survey, 2012 (Statistics Canada); Canadian Community Health Survey, 2012 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Indigenous Cancer Care Unit)
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Inuit population outside Inuit Nunangat (from the 2006 Census).
2. High sampling variability in data for Inuit in Ontario. Interpret with caution.

Data Table 2: Percentage of Inuit adults in Canada and non-Aboriginal adults in Ontario (ages 20 and older) who smoked daily or occasionally, by sex, 2012
	Non-Aboriginal in Ontario	Non-Aboriginal in Ontario	Non-Aboriginal in Ontario	Inuit outside Nunangat	Inuit outside Nunangat	Inuit outside Nunangat	Inuit inside Nunangat	Inuit inside Nunangat	Inuit inside Nunangat
Overall	22.6	20.9	24.3	37.1	29.8	44.4	73.9	71.6	76.2
Men	26.9	24.4	29.4	32.6	20.7	44.4	73.2	70	76.4
Women	18.4	16.3	20.6	40.9	31.5	50.3	74.4	71.2	77.7

Report date: April 2017
Data source: Aboriginal Peoples Survey, 2012 (Statistics Canada); Canadian Community Health Survey, 2012 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Indigenous Cancer Care Unit)
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Inuit population outside Inuit Nunangat (from the 2006 Census).
2. High sampling variability in data for Inuit men outside Nunangat. Interpret with caution.

Data Table 3: Percentage of Inuit adults in Canada and non-Aboriginal adults in Ontario (ages 19 and older) who had 5 or more alcoholic drinks on 1 occasion at least 2 to 3 times per month in the past year, by sex, 2012
	Non-Aboriginal in Ontario	Non-Aboriginal in Ontario	Non-Aboriginal in Ontario	Inuit outside Nunangat	Inuit outside Nunangat	Inuit outside Nunangat	Inuit inside Nunangat	Inuit inside Nunangat	Inuit inside Nunangat
Overall	14.7	13.5	15.9	18.9	13.9	23.9	17.7	16	19.4
Men	20.8	18.7	22.8	26	16	36.1	20.1	17.5	22.6
Women	8.7	7.3	10	12.7	8	17.3	12.6	10.8	14.5

Report date: March 2018
Data source: Aboriginal Peoples Survey, 2012 (Statistics Canada); Canadian Community Health Survey, 2012 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Indigenous Cancer Care Unit)
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Inuit population outside Inuit Nunangat (from the 2006 Census.
2. High sampling variability in data for Inuit outside Nunangat. Interpret with caution.

Report date: April 2017
Data source: Aboriginal Peoples Survey, 2012 (Statistics Canada); Canadian Community Health Survey, 2012 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Indigenous Cancer Care Unit)
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Inuit population outside Inuit Nunangat (from the 2006 Census).
2. High sampling variability in data for Inuit in Ontario. Interpret with caution.

Data Table 4: Percentage of Inuit adults in Canada and non-Aboriginal adults in Ontario (ages 18 and older) who had excess body weight (obese and overweight combined), by sex, 2012
	Inuit in Ontario	Inuit in Ontario	Inuit in Ontario	Inuit in Nunangat	Inuit in Nunangat	Inuit in Nunangat	Non-Aboriginal in Ontario	Non-Aboriginal in Ontario	Non-Aboriginal in Ontario
Men	49.1	28.4	69.8	48.3	44.7	51.8	54.9	52.3	57.5
Women	59.5	41.7	78.2	55.6	51.5	59.6	41	38.7	43.3

Report date: April 2017
Data source: Aboriginal Peoples Survey, 2012 (Statistics Canada); Canadian Community Health Survey, 2012 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Indigenous Cancer Care Unit)

Notes:
1. Estimates are adjusted to the age distribution of the 2006 Inuit population outside Inuit Nunangat (from the 2006 Census).
2. Lines on the bars represent 95% confidence intervals.
3. † indicates high sampling variability for Inuit men in Ontario. Interpret with caution.
4. Overweight and obesity are defined by Body Mass Index (BMI) values.
5. Overweight: BMI 25 to 29.99. Obesity: BMI 30 or greater.

Data Table 1: Percentage of Inuit and non-Aboriginal adults (ages 20 and older) who smoked daily or occasionally, Ontario, 2012

Data Table 2: Percentage of Inuit adults in Canada and non-Aboriginal adults in Ontario (ages 20 and older) who smoked daily or occasionally, by sex, 2012

Data Table 3: Percentage of Inuit adults in Canada and non-Aboriginal adults in Ontario (ages 19 and older) who had 5 or more alcoholic drinks on 1 occasion at least 2 to 3 times per month in the past year, by sex, 2012

Data Table 4: Percentage of Inuit adults in Canada and non-Aboriginal adults in Ontario (ages 18 and older) who had excess body weight (obese and overweight combined), by sex, 2012

Results

Cigarette smoking

Cigarette smoking is associated with some cancers, including lung and colorectal cancers.
In Ontario, about 34% of Inuit adults smoked cigarettes, compared with 23% of non-Aboriginal adults. This difference was not statistically significant. The estimated percentage of Inuit in Ontario who smoke is similar to that of all Inuit outside Nunangat (37%).
The prevalence of cigarette smoking was highest among Inuit living in Nunangat, where about three-quarters of Inuit adults reported smoking cigarettes daily or occasionally (73% of Inuit men and 74% of Inuit women). Cigarette smoking was significantly more common in Inuit men and women living in Nunangat than in Inuit living outside Nunangat or non-Aboriginal Ontarians.
A significantly higher proportion of Inuit women living outside Nunangat (41%) than non-Aboriginal Ontario women (18%) smoked cigarettes daily or occasionally. About 33% of Inuit men living outside Nunangat smoked cigarettes compared with 27% of non-Aboriginal men in Ontario.

Alcohol consumption

Drinking alcohol increases risk for many cancers, including colorectal and breast cancers.
Similar proportions of Inuit men living outside Nunangat (26%), Inuit men living in Nunangat (20%) and non-Aboriginal men living in Ontario (21%) reported binge drinking in the past year. Binge drinking is having 5 or more alcoholic drinks on 1 occasion at least 2 to 3 times a month.
The proportion of binge drinking was 13% among Inuit women living both in and outside Nunangat, but significantly lower (9%) among non-Aboriginal women in Ontario.

Obesity

Increased body fatness is associated with many cancers, including the 2 most commonly diagnosed cancers in Ontario: colorectal and breast (post-menopausal).
A higher proportion of Inuit women living in Ontario (60%) had excess body weight — that is, were overweight or obese — than non-Aboriginal women living in Ontario (41%). Inuit men in Ontario (49%) had about the same prevalence of excess body weight as non-Aboriginal men (55%).
The proportion of Inuit women inside (28%) and outside Nunangat (30%) who were obese was nearly twice that of non-Aboriginal women living in Ontario (17%). About 20% of Inuit men living in Nunangat and 24% of men living outside Nunangat were obese, compared with 16% of non-Aboriginal men in Ontario. These differences among men were not statistically significant.
Being overweight was about as common in Inuit women living outside Nunangat as it was in Inuit women living inside Nunangat and in non-Aboriginal women in Ontario. A lower proportion of Inuit men living inside Nunangat (28%) were overweight than non-Aboriginal men in Ontario (38%).

Opportunities

Very little is known about cancer risk and burden among Inuit outside Nunangat. Therefore, studying information about the prevalence of cancer risk factors may be the best way to determine where to direct cancer prevention resources most effectively to reduce the future burden of cancer and other chronic diseases.
Tungasuvvingat Inuit and Cancer Care Ontario produced Cancer Risk Factors & Screening among Inuit in Ontario and Other Canadian Regions. The report provides essential evidence that Inuit communities can use to support cancer prevention and screening.
With their current high rates of cigarette smoking, Inuit both in and outside Nunangat are expected to experience a substantial future burden of tobacco-related chronic disease. Strategies, policies and programs to reduce smoking should therefore be a priority. Smoking cessation interventions should consider the many factors that influence the high smoking prevalence among Inuit from a holistic perspective.
CCO’s Path to Prevention: Recommendations for Addressing Chronic Disease in First Nation, Inuit and Métis, outlines evidence-based policy recommendations to guide decision-making related to chronic disease prevention policy for First Nations, Inuit and Métis groups. The report focuses on the 4 major risk or protective factors for chronic disease: commercial tobacco use, alcohol consumption, physical activity and healthy eating. While the recommendations are aimed at the Government of Ontario, their implementation will involve full participation by First Nations, Inuit and Métis partners, as well as collaboration with a range of organizations.