Access to radiotherapy among circumpolar Inuit populations

Chan, Jessica; Friborg, Jeppe; Chernov, Mikhail; Cherkashin, Mikhail; Grau, Cai; Brundage, Michael; Slotman, Ben J.

doi:10.1016/s1470-2045(19)30394-8

Cited by 13 publications

(24 citation statements)

References 34 publications

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“…The high rate of cancellations and no-shows we observed raises an important issues in health system access and resource utilisation. The reasons for cancellation we identified align with barriers to healthcare previously identified in for circumpolar north populations: physical geography, communication, sociocultural and systemic factors [1,22]. As such, the reasons and trends of colonoscopy cancellations identified in this study may provide critical insight for providers and policy-makers working to improve access to specialist care in other northern regions.…”

Section: Discussionsupporting

confidence: 66%

Barriers to colonoscopy in remote northern Canada: an analysis of cancellations

Smith

Brunet

Tessier³

et al. 2020

International Journal of Circumpolar Health

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Background: Colonoscopy is a critical diagnostic and therapeutic procedure that is challenging to access in northern Canada. In part, this is due to frequent cancellations. We sought to understand the trends and reasons for colonoscopy cancellations in the Northwest Territories (NWT). Methods: A retrospective review of colonoscopy cancellations January, 2018 to May, 2019 was conducted at Stanton Territorial Hospital, NWT. Cancellation details and rationale were captured from the endoscopy cancellation logs. Thematic analysis was used to group cancellation reasons. Descriptive statistics were generated, and trends were analysed using run chart. Results: Of the scheduled colonoscopies, 368(28%) were cancelled during the 16 month period, and cancellations occurred, on average, 27 days after booking. Cancellation reasons were grouped into 15 themes, encompassing personal, social, geographic and health system factors. The most frequently cited theme was work/other commitments (69 respondents; 24%). Cancellations due to travel and accommodation issues occurred more frequently in the winter. Conclusion: Over one in four booked colonoscopies were cancelled and the reasons for cancellations were complex. Initiatives focusing on communication and support for patients with personal or occupational obligations could dramatically reduce cancellations. Ongoing collaborative efforts are needed to inform and optimise access to colonoscopy in this region.

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Section: Discussionsupporting

confidence: 66%

Barriers to colonoscopy in remote northern Canada: an analysis of cancellations

Smith

Brunet

Tessier³

et al. 2020

International Journal of Circumpolar Health

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“…NORDCAN revealed that the incidence of breast cancer in Greenland was much lower than other Nordic countries while the mortality of breast cancer was approximately the same (30). Access to radiotherapy is lacking or absent in many Inuit regions, despite it being an essential component of cancer treatment (31). Therefore, breast cancer still imposes a considerable burden on health system in Greenland and other Inuit regions.…”

Section: Discussionmentioning

confidence: 99%

The Global, Regional, and National Burden and Trends of Breast Cancer From 1990 to 2019: Results From the Global Burden of Disease Study 2019

Xu¹,

Liu

Zhang

et al. 2021

Front. Oncol.

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BackgroundThe burden of breast cancer has been increasing globally. The epidemiology burden and trends need to be updated. This study aimed to update the burden and trends of breast cancer incidences, deaths, and disability-adjusted life-years (DALYs) from 1990 to 2019, using the Global Burden of Disease 2019 study.MethodsThe data of incidences, deaths, DALYs, and age-standardized rates were extracted. Estimated annual percentage changes were used to quantify the trends of age-standardized rates. Besides, the population attributable fractions of the risk factors of breast cancer were also estimated.ResultsGlobally, the incidences of breast cancer increased to 2,002,354 in 2019. High social-development index (SDI) quintiles had the highest incidence cases with a declining trend in age-standardized incidence rate. In 2019, the global deaths and DALYs of breast cancer increased to 700,660 and 20,625,313, respectively. From 1990 to 2019, the age-standardized mortality rates and age-standardized DALY rates declined globally, especially in high and high-middle SDI quintiles. Besides, the trends varied from different regions and countries. The proportion of the patients in the 70+ years age group increased globally. Deaths of breast cancer attributable to high fasting plasma glucose and high body mass index increased globally, and high fasting plasma glucose was the greatest contributor to the global breast cancer deaths.ConclusionThe burden of breast cancer in higher SDI quintiles had gone down while the burden was still on the rise in lower SDI quintiles. It is necessary to appeal to the public to decrease the exposure of the risk factors.

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“…Authors reported several justifications for their research: (1) overcome knowledge gaps, 22 42 49 (2) describe disease burden, risk factors and adverse outcomes, [50][51][52][53][54][55][56][57] (3) explore and highlight health disparities, 49 58-63 (4) inform development or improvement of health services and programmes, 49 64-66 and ( 5) respond to local public health authorities/community requests and support Inuit-led research and programmes. [67][68][69][70][71][72][73][74] Implementation Inception, protocols and decision-making process Studies reported involvement of political and health authorities from the different Inuit regions.…”

Section: Framing Health Issues and Justificationmentioning

confidence: 99%

Shifting paradigm from biomedical to decolonised methods in Inuit public health research in Canada: a scoping review

et al. 2022

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BackgroundThe National Inuit Strategy on Research focuses on advancing Inuit governance in research, increasing ownership over data and building capacity. Responding to this call for Inuit self-determination in research, academic researchers should consider cultural safety in research and ways to promote Inuit-led methods.MethodsThis scoping review collated academic literature on public health research in Inuit communities in Canada between 2010 and 2022. A critical assessment of methods used in public health research in Inuit communities examined cultural safety and the use of Inuit-attuned methods. Descriptive and analytical data were summarised in tables and figures. Knowledge user engagement in the research process was analysed with thematic analysis.Results356 articles met the inclusion criteria. Much of the published research was in nutrition and mental health, and few initiatives reported translation into promotion programmes. Almost all published research was disease or deficit focused and based on a biomedical paradigm, especially in toxicology, maternal health and chronic diseases. Recent years saw an increased number of participatory studies using a decolonial lens and focusing on resilience. While some qualitative research referred to Inuit methodologies and engaged communities in the research process, most quantitative research was not culturally safe. Overall, community engagement remained in early stages of co-designing research protocols and interventions. Discussion on governance and data ownership was limited. Recent years saw emerging discussions on these issues. Knowledge user capacity-building was limited to brief training on conventional data collection methods.ConclusionsThe last decade of published public health research has not responded to the National Inuit Strategy on Research. Participatory research is gaining ground, but has not reached its full potential. A shift from biomedical to decolonised methods is slowly taking place, and public health researchers who have not yet embraced this paradigm shift should do so.

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Access to radiotherapy among circumpolar Inuit populations

Cited by 13 publications

References 34 publications

Barriers to colonoscopy in remote northern Canada: an analysis of cancellations

Barriers to colonoscopy in remote northern Canada: an analysis of cancellations

The Global, Regional, and National Burden and Trends of Breast Cancer From 1990 to 2019: Results From the Global Burden of Disease Study 2019

Shifting paradigm from biomedical to decolonised methods in Inuit public health research in Canada: a scoping review

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