Cancer Incidence, Mortality, and Stage at Diagnosis in First Nations Living in Manitoba

Decker, Kathleen; Kliewer, Erich V.; Demers, Alain; Fradette, Katherine; Biswanger, Natalie; Musto, Grace; Elias, Brenda; Turner, Donna

doi:10.3747/co.23.2906

Cited by 20 publications

(22 citation statements)

References 36 publications

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“…Our results support the large literature documenting delayed diagnoses for individuals vulnerable to health inequities and an established evidence base documenting worse cancer survival for individuals in marginalised populations 35 55–62. We identified a greater need to support individuals living with severe mental illness, such as schizophrenia, through the cancer continuum.…”

Section: Discussionsupporting

confidence: 82%

Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis

Davis

Bogner

Coburn

et al. 2019

J Epidemiol Community Health

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IntroductionIndividuals with a pre-existing mental illness, especially those experiencing reduced social, occupational and functional capacity, are at risk for cancer care disparities. However, uncertainty surrounding the effect of a mental illness on cancer outcomes exists.MethodsWe conducted a systematic review and meta-analysis of observational studies using MEDLINE and PubMed from 1 January 2005 to 1 November 2018. Two reviewers evaluated citations for inclusion. Advanced stage was defined as regional, metastatic or according to a classification system. Cancer survival was defined as time survived from cancer diagnosis. Pooled ORs and HRs were presented. The Newcastle-Ottawa bias risk assessment scale was used. Random-effects models used the Mantel-Haenszel approach and the generic inverse variance method. Heterogeneity assessment was performed using I2.Results2381 citations were identified; 28 studies were included and 24 contributed to the meta-analysis. Many demonstrated methodological flaws, limiting interpretation and contributing to significant heterogeneity. Data source selection, definitions of a mental illness, outcomes and their measurement, and overadjustment for causal pathway variables influenced effect sizes. Pooled analyses suggested individuals with a pre-existing mental disorder have a higher odds of advanced stage cancer at diagnosis and are at risk of worse cancer survival. Individuals with more severe mental illness, such as schizophrenia, are at a greater risk for cancer disparities.DiscussionThis review identified critical gaps in research investigating cancer stage at diagnosis and survival for individuals with pre-existing mental illness. High-quality research is necessary to support quality improvement for the care of psychiatric patients and their families during and following a cancer diagnosis.

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Section: Discussionsupporting

confidence: 82%

Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis

Davis

Bogner

Coburn

et al. 2019

J Epidemiol Community Health

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“…In Manitoba, First Nation ethnicity was not associated with stage at colorectal cancer diagnosis (33). In studies from Manitoba and Ontario, however, First Nation women were more likely than non-First Nations to be diagnosed with breast cancer at a later stage (33,34) In Ontario, differences in survival between First Nations and non-First Nations were only present among women diagnosed with stage I breast cancer (35). Internationally, stage has only been found to account for a portion of the survival disparity between indigenous and no indigenous persons, and stage-specific ethnic disparities persist (36)(37)(38).…”

Section: Discussionmentioning

confidence: 88%

“…Studies of stage distribution among Aboriginal people in Canada are limited and have shown mixed results. In Manitoba, First Nation ethnicity was not associated with stage at colorectal cancer diagnosis (33). In studies from Manitoba and Ontario, however, First Nation women were more likely than non-First Nations to be diagnosed with breast cancer at a later stage (33,34) In Ontario, differences in survival between First Nations and non-First Nations were only present among women diagnosed with stage I breast cancer (35).…”

Section: Discussionmentioning

confidence: 94%

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Cancer Survival Disparities Between First Nation and Non-Aboriginal Adults in Canada: Follow-up of the 1991 Census Mortality Cohort

Withrow

Pole

Nishri

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…24 The reasons for this change in CRC epidemiology is likely multifactorial, including changing lifestyles, increasing prevalence of CRC risk factors (such as smoking and obesity), and lower CRC screening rates in First Nation communities. 25,26 In multivariable analysis, we are reporting higher CRC incidence in rural areas, which suggests that these areas should be one of the foci of CRC reduction initiatives in Manitoba.…”

Section: Crc Incidence By Sgas Of Residence In Manitobamentioning

confidence: 99%

Geographic variation and factors associated with colorectal cancer incidence in Manitoba

Singh

Nugent

Decker

et al. 2017

Can J Public Health

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OBJECTIVES: Although individuals living in areas with lower household income have been shown to have higher rates of mortality from colorectal cancer (CRC), findings on the effect of income on CRC incidence in countries with universal health care have been inconsistent. There are limited data from Canada. We investigated the geographic variation and factors associated with CRC incidence in Manitoba, a central Canadian province. METHODS:The Manitoba Cancer Registry and Manitoba Health population registry were used to determine age-sex-standardized CRC incidence rates between 1985 and 2012, which were geocoded to 498 small geographic areas (SGAs). The 2001 Canadian Census was used to determine the sociodemographic characteristics of the SGAs. Bayesian spatial Poisson modelling was used to assess geographic variation and factors associated with CRC incidence.RESULTS: CRC incidence in SGAs ranged from 11 to 1026 per 100 000 population per year. Importantly, in the fully adjusted model there was no significant association between either average household income or proportion of recent immigrants in the SGAs and CRC incidence. Individuals living in urban areas had an overall lower CRC incidence (incidence rate ratio: 0.76; 95% credible interval: 0.58-0.98). CONCLUSIONS:In a province with a universal health care system, our study suggests there are no disparities in CRC incidence by socio-economic level of the areas of residence. Rural areas should be a focus of CRC reduction initiatives in Manitoba. Similar analysis in other jurisdictions should be performed to evaluate the effect of the characteristics of SGAs on CRC incidence in different settings and target some of the efforts to reduce CRC burden.KEY WORDS: Epidemiology; spatial analysis; variation in risk; disparities La traduction du résumé se trouve à la fin de l'article.

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Cancer Incidence, Mortality, and Stage at Diagnosis in First Nations Living in Manitoba

Abstract: BackgroundIn the present study, we examined breast (bca) and colorectal cancer (crc) incidence and mortality

Cited by 20 publications

References 36 publications

Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis

Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis

Cancer Survival Disparities Between First Nation and Non-Aboriginal Adults in Canada: Follow-up of the 1991 Census Mortality Cohort

Geographic variation and factors associated with colorectal cancer incidence in Manitoba

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