Epidemiology of prostate and kidney cancer in the Aboriginal population of Canada: A systematic review

Abstract

Introduction: Prostate and kidney cancer rates in the Aboriginal population of Canada is a growing issue. Methods: A systematic review of prostate and kidney cancer epidemiology in the Aboriginal population of Canada was performed with international comparison and evaluation of present epidemiological disparities. PubMed, Medline, and Embase (from January 1946 to June 2016), relevant government-published reports, and the websites of organizations contributing to prostate or kidney cancer guidelines were searched. We included studies that informed any of the three epidemiological questions this review is focused on answering. Results: Two systematic reviews, two meta-analyses, five literature reviews, and 21 single-study papers were included. The incidence and mortality rates of kidney cancer were elevated among Canadian Aboriginals when compared to the provincial or national population and to several international regions. No studies reported data on survival. Prostate cancer incidence, mortality, and survival rates were lower in Aboriginals provincially, nationally, and internationally, with incidence and survival reaching statistical significance. Elevated rate of risk factors for kidney cancer was a significant finding among Canadian Aboriginals. Aboriginals were screened for prostate cancer less than the general Canadian population, a trend also observed in the U.S. Conclusions:The elevated incidence and mortality of kidney cancer among Canadian Aboriginals is most likely attributable to the rise in lifestyle-based risk factors. Two correlations concerning prostate cancer are made. However, due to temporal and regional disparities in data, further investigation is required to elucidate these observations. IntroductionIn Canada, the term "Aboriginal" is used to describe individuals who identify as First Nations (North American Indian), Métis, or Inuk (Inuit).1 According to the 2011 National Household Survey, 1 400 685 Canadians identified as being Aboriginal, comprising 4.3% of the Canadian population.1 Provincially, Ontario has the largest population of Aboriginal people in Canada, with 301 425 Aboriginal residents.1 Prostate cancer is the most commonly diagnosed malignancy among males in Canada, while kidney cancer ranks sixth. Renal cell carcinoma (RCC) is the most common morphology of kidney cancer, accounting for 80% of cases. 2Prostate and kidney cancer among Aboriginals of Canada is of particular concern due to the lack of current data on screening, treatment, and surveillance. [3][4][5][6] There are three points of interest for comparison in this review:1. Incidence, mortality, and survival rates 2. Risk factor prevalence 3. Screening guidelines The goal of this review is to answer three epidemiological questions:1. How do Aboriginals of Canada compare provincially, nationally, and internationally with regards to prostate and kidney cancer incidence, mortality, and survival? 2. What risk factor is the most contributory to the development of prostate and kidney cancer among Aboriginals of Canad...

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