First Nations Cancer Burden
- 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.
- A limitation of this work is that the data do not go beyond the year 2010. Although these data are a little out of date, cancer patterns generally do not change dramatically year over year. However, significant investments and advancements have been made in malignant hematology care in the past 5 years.
- Specifically for malignant hematology, information on sub-sites was not captured due to the small number of cases diagnosed in First Nations people. As well, age-standardization may differ from other data in the Cancer System Quality Index. Find more information in the corresponding methodology pages.
For technical information, see:
- Cancer Incidence in First Nations Peoples in Ontario Methodology
- Cancer Mortality in First Nations Peoples in Ontario Methodology
- Cancer Survival in First Nations Peoples in Ontario Methodology
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.
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.
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.
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.
First Nations males have a lower incidence of leukemia compared to other males in Ontario (7 new cases per 100,000 and 12 new cases per 100,000, respectively). Incidence of leukemia is similar among First Nations females and other females in Ontario.
Over a third (37%) of First Nations males diagnosed with leukemia survived five years or longer compared to half (50%) of other males in Ontario (not statistically significant).
First Nations females diagnosed with leukemia have poorer survival than other females in Ontario. Less than a third of First Nations females (30%) survived five years or longer after the diagnosis, compared to half (53%) of other females in Ontario.
Incidence of myeloma was higher in First Nations females compared to other females in Ontario. In Ontario, five new cases of myeloma per 100,000 people were diagnosed in First Nations females compared to three new cases per 100,000 people in other females in Ontario.
In males, incidence of myeloma was similar among both groups with five new cases per 100,000 people in First Nations males and four new cases per 100,000 people in other males in Ontario.
First Nations males had poorer five-year survival for myeloma than other males in Ontario. Almost a fifth (19%) of First Nations males with myeloma survived for at least five years after their cancer diagnosis, compared to 39% of other males in Ontario. Five-year survival for myeloma among First Nations females was 29% compared 42% among other females in Ontario.
- 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 are needed to understand why cancer rates differ between First Nations people and other people in Ontario, and how these differences can be addressed.
- In particular, for malignant hematology, more analysis of current rates (post 2010) is needed for an up-to-date understanding of trends in incidence and outcomes.
For more information
- Chiefs of Ontario, Institute for Clinical Evaluative Sciences and Cancer Care Ontario have produced Cancer in First Nations People in Ontario: Incidence, Mortality, Survival and Prevalence. This report highlights cancer burden for First Nations peoples from 1991 to 2010.