A newly-released report by the Sioux Lookout First Nations Health Authority (SLFNHA) on cancer has pointed to several disparities for First Nations, including higher rates of specific cancers, gaps in screening and inconsistent access to appointments.
The research covered the 16-year-period between 2006 and 2022 and focused on the 33 First Nations covered by the health authority, 28 of which are remote.
Lloyd Douglas, public health physician with SLFNHA, said the study found a number of factors are impacting access to services. These include geographical remoteness, oppressive government policies and programs, and systemic barriers, he said.
“The storytellers are saying that, in terms of health-care service on reserve, there is reduced capacity and infrastructure,” Douglas said on CBC’s Superior Morning.
“In terms of the quantitative data, we have realized that colorectal cancer is the most common cancer … followed by breast, lung, kidney, prostate and cervical cancer. We also found that the incidence in some cancers [is] higher when compared to other jurisdictions in the province.”
According to the report, colorectal cancer accounts for one in six cancer cases in Sioux Lookout, followed by breast cancer, lung cancer, kidney cancer, prostate cancer and cervical cancer, Douglas said.
“While the overall incident rate for all cancers was lower among First Nations in this region, when we take a closer look, for example at colorectal cancer and kidney cancer, we find that there are higher incidence rates for both of them among males and females when compared to Ontario,” he said.
“Also for males, we’re seeing a higher incident rate of lung and prostate cancer. For breast cancer, females have a lower incidence rate of breast cancer and lung cancer when compared to other females in Ontario. But for cervical cancer, we’re seeing higher rates when compared to Ontario.”
While cancer screening services are available in the First Nations, Douglas said women must travel outside of their communities to have a mammogram done.
Janet Gordon, vice president of community health at SLFNHA, said the report has highlighted several key factors getting in the way of proper diagnosis and treatment of cancer for people in First Nations.
“One of the challenges in all of our communities is certainly staffing — like nurses and physicians — so access is a huge issue,” she said.
“Our communities deal with crisis situations all the time, so things like screening does not happen on a regular basis. I think getting into seeing a physician or nurse is sometimes hard and maybe the concerns that people have are not taken seriously.
“If they do have appointments, the system is not great because it does not support people. People sometimes will miss appointments because they are not told ahead of time. Travel is an issue with weather … so people miss their appointments that are crucial and then another appointment could take months,” Gordon said.
One of the stories that we hear over and over again is that people just feel like they’re not being heard, they get dismissed
Additionally, Gordon said people sometimes feel they’re not being listened to when they have concerns or they’re not taken seriously. This, she said, often leads to people getting a late diagnosis.
“One of the stories that we hear over and over again is that people just feel like they’re not being heard, they get dismissed,” Gordon said.
“So they don’t go back again until they’re really sick — we hear that so much when we talk to people.”
Meanwhile, Douglas said there are things that can be done immediately to address issues highlighted in the report.
“With regards to cancer screening, I think much can be done. I think one great idea, especially for breast cancer screening, could we take that to the community rather than having individuals travel from the community?”
“Also, the critical infrastructure. Ensuring that at the nursing station we have dedicated space for screening, and also ensuring that we have additional resources like nurses. We need to increase the number of these nurses at the community level, so that we can have these services offered.
“In the long term, we need an overall cancer strategy and we need to develop a cancer complex care kind of service, which will follow a patient right through the entire process, early screening to diagnosis to treatment,” added Douglas.
