Modifiable Risk Factors for Cancer in the Métis Peoples of Ontario

Key findings:

Métis people in Ontario have higher prevalence of certain cancer risk factors, including higher cigarette smoking, obesity and exceeding cancer prevention guidelines for drinking alcohol (males).
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 Métis Methodology for technical information.

Report date: March 2016
Data source: Canadian Community Health Survey (CCHS), 2007–2014 (Statistics Canada)
Prepared by: Cancer Care Ontario, Indigenous Cancer Care Unit and the Métis Nation of Ontario, Healing and Wellness Branch
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Ontario Aboriginal identity population (from the 2006 Census).
2. † indicates high sampling variability in data for Métis teens. Interpret with caution.
3. Lines on the bars represent 95% confidence intervals.

Report date: March 2016
Data source: Canadian Community Health Survey (CCHS), 2007–2014 (Statistics Canada)
Prepared by: Cancer Care Ontario, Indigenous Cancer Care Unit and the Métis Nation of Ontario, Healing and Wellness Branch
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Ontario Aboriginal identity population (from the 2006 Census).
2. † indicates high sampling variability in Métis data for 2010 and 2011. Interpret with caution.

Report date: April 2017
Data source: Canadian Community Health Survey, 2007-2014 (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 Ontario Aboriginal Identity population.
2. Lines on the bars represent 95% confidence intervals.

Report date: March 2016
Data source: Canadian Community Health Survey (CCHS), 2007–2014 (Statistics Canada)
Prepared by: Cancer Care Ontario, Indigenous Cancer Care Unit and the Métis Nation of Ontario, Healing and Wellness Branch
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Ontario Aboriginal identity population (from the 2006 Census).
2. Lines on the bars represent 95% confidence intervals.

Report date: 2015
Data source: Canadian Community Health Survey (CCHS), 2007–2012 (Statistics Canada)
Prepared by: Cancer Care Ontario, Indigenous Cancer Care Unit and Métis Nation Ontario
Notes: Lines on the bars represent 95% confidence intervals.

Data Table 1: Modifiable Risk Factors for Cancer in the Métis Peoples of Ontario
	Métis	Métis	Métis	Non-Aboriginal	Non-Aboriginal	Non-Aboriginal
Teens	15.6	10.2	20.9	7.2	6.6	7.8
Adults	36.2	32.7	39.6	21.4	21	21.9

Report date: March 2016
Data source: Canadian Community Health Survey (CCHS), 2007–2014 (Statistics Canada)
Prepared by: Cancer Care Ontario, Indigenous Cancer Care Unit and the Métis Nation of Ontario, Healing and Wellness Branch
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Ontario Aboriginal identity population (from the 2006 Census).
2. High sampling variability in data for Métis teens. Interpret with caution.

Data Table 2: Percentage of Métis and non-Aboriginal adults (ages 20 and older) who smoked daily or occasionally, by year, Ontario, 2007 to 2014
	On-reserve First Nations	Off-reserve First Nations	Non-Aboriginal
2007		50.7	23.5
2008		45.3	22.4
2009		45.3	22.4
2010	49.8	44.5	21.6
2011		39.6	21.9
2012		42.6	21.4
2013		38.7	20.5

Report date: March 2016
Data source: Canadian Community Health Survey (CCHS), 2007–2014 (Statistics Canada)
Prepared by: Cancer Care Ontario, Indigenous Cancer Care Unit and the Métis Nation of Ontario, Healing and Wellness Branch
Notes:
1. Estimates are adjusted to the age distribution of the 2006 Ontario Aboriginal identity population (from the 2006 Census).
2. High sampling variability in Métis data for 2010 and 2011. Interpret with caution.

Data Table 3: Percentage of Métis and non-Aboriginal adolescents (ages 12 to 17) and adults (ages 18 and older) who were obese, Ontario
	Métis	Métis	Métis	Non-Aboriginal	Non-Aboriginal	Non-Aboriginal
Adolescents	8	4.3	12	4.6	4.1	5.2
Adults	24.6	20.8	28.4	17.8	17.5	18.2

Report date: April 2017
Data source: Canadian Community Health Survey, 2007–2014 (Statistics Canada)
Prepared by: Cancer Care Ontario, Prevention and Cancer Control (Indigenous Cancer Care Unit)
Notes: Estimates are adjusted to the age distribution of the 2006 Ontario Aboriginal Identity population.

Data Table 4: Percentage of Métis and non-Aboriginal adults (ages 19 and older) drinking alcohol in excess of cancer prevention guidelines, by sex, Ontario
	Métis	Métis	Métis	Non-Aboriginal	Non-Aboriginal	Non-Aboriginal
Males	15.2	11.3	19	9.6	9.2	10
Females	9.6	6.5	12.6	8.5	8.1	8.9

Report date: April 2017
Data source: Canadian Community Health Survey, 2007–2014 (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 Ontario Aboriginal Identity population.

Data Table 5: Percentage of Métis and non-Aboriginal adults (ages 18 and older) and adolescents (ages 12 to 17) who reported consuming vegetables and fruit 5 or more times a day, 2007 to 2014 combined
	Métis	Métis	Métis	Non-Aboriginal	Non-Aboriginal	Non-Aboriginal
Adult	24.8	21.4	28.3	28.7	28.3	29.2
Adolescent	39.9	31.5	48.4	39.4	38.2	40.6

Data Table 6: Percentage of Ontario adults (ages 20 and older) who were physically inactive, by sex, 2007 to 2012
	Métis	Métis	Métis	Non-Aboriginal	Non-Aboriginal	Non-Aboriginal
Males	47.3	40.7	53.9	47.3	46.3	48.2
Females	47.3	40.3	54.3	52.7	51.9	53.5

Data Table 1: Modifiable Risk Factors for Cancer in the Métis Peoples of Ontario

Data Table 2: Percentage of Métis and non-Aboriginal adults (ages 20 and older) who smoked daily or occasionally, by year, Ontario, 2007 to 2014

Data Table 3: Percentage of Métis and non-Aboriginal adolescents (ages 12 to 17) and adults (ages 18 and older) who were obese, Ontario

Data Table 4: Percentage of Métis and non-Aboriginal adults (ages 19 and older) drinking alcohol in excess of cancer prevention guidelines, by sex, Ontario

Data Table 5: Percentage of Métis and non-Aboriginal adults (ages 18 and older) and adolescents (ages 12 to 17) who reported consuming vegetables and fruit 5 or more times a day, 2007 to 2014 combined

Data Table 6: Percentage of Ontario adults (ages 20 and older) who were physically inactive, by sex, 2007 to 2012

Results

Cigarette smoking

Cigarette smoking is associated with some cancers, including lung and colorectal cancers.
Métis teens and adults had a higher prevalence of cigarette smoking (16% and 36%, respectively) compared with non-Aboriginal teens and adults (7.2% and 21%, respectively).
Smoking rates among Métis adults decreased from 44% in 2007 to 32% in 2014.

Obesity

Increased body fatness is associated with many cancers, including the 2 most commonly diagnosed cancers in Ontario: colorectal and breast (post-menopausal).
The prevalence of obesity was significantly higher in Métis adults (25%) compared with non-Aboriginal adults (18%). Métis teens also had a high prevalence of obesity but it was not significantly higher than non-Aboriginal teens.

Alcohol

Drinking alcohol increases risk for many cancers, including colorectal and breast cancers.
Métis men were significantly more likely than non-Aboriginal men (15% and 10%, respectively) to exceed the cancer prevention guideline of no more than 2 alcoholic drinks per day. A similar proportion of Métis and non-Aboriginal women exceeded the cancer prevention guideline.

Vegetables and fruit consumption

Consuming a diet high in vegetables, fruit and dietary fibre lowers the risk of several cancers, including colorectal cancer. Conversely, a diet high in red meats and processed foods increases the risk of colorectal cancer.
A similar proportion of Métis and non-Aboriginal people consume fewer than 5 servings of fruits and vegetables per day.

Physical activity

Regular physical activity has been associated with reduced risk of some cancers, including colorectal cancer.
Similar proportions of Métis and non-Aboriginal adults are physically inactive.

Opportunities

Very little is known about cancer rates among the Métis people of Ontario. 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.
With their current high rates of cigarette smoking, Métis populations 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 historical role that tobacco has played in the Métis way of life over many hundreds of years.
The Indigenous Tobacco Program at Cancer Care Ontario aims to reduce non-traditional tobacco use and second-hand smoke exposure in First Nations, Inuit and Métis communities. The program develops and delivers culturally appropriate awareness and education initiatives. These activities communities build capacity to prevent commercial tobacco use, help people quit and protect people from second-hand exposure.
Geography is an important issue for the many Métis people living in smaller urban centres or rural environments in Ontario, where there are challenges in getting prevention and treatment support. Improving access to resources and services is critical to system-level interventions designed to reduce cancer risk and improve Métis health outcomes.
Métis Nation of Ontario and Cancer Care Ontario have produced Cancer in the Métis People in Ontario: Risk Factors and Screening Behaviours. The report provides essential evidence that Métis communities can use to support cancer prevention and screening.
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 about chronic disease prevention policy for First Nations, Inuit and Métis. 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.