Indigenous Patients & Breast Cancer

Breast cancer in Canada: Breast cancer is the most common cancer among women in Canada, for both Indigenous and non-Indigenous Canadian women.¹ Breast cancer occurs when cells in breast tissue grow out of control and accumulate, creating tumours.

Differences in cancer stage diagnoses: Indigenous communities lack equal access to breast cancer screening and prevention programs. Breast cancer is diagnosed at later stages in Indigenous patients.² In Manitoba, First Nations women were had lower prevalence of breast cancer compared to non-Aboriginal Manitobans but they were diagnosed with later-stage cancer and had poorer survival rates.² In Ontario, First Nations women who were overweight or obese had a higher likelihood of receiving a late-stage diagnosis.³ Early screening and diagnosis can improve outcomes; thus, it is important to encourage breast cancer screening in Indigenous populations.

Differences in survival rates and outcomes: Poverty and negative social conditions influenced by the lasting effects of colonialism and institutional discrimination can affect cancer incidence, survival, and prevention. Indigenous breast cancer patients show lower survival rates, and this lower rate remains when income and regional rurality is accounted for.⁴ However, lower incomes contribute to an increased difference in survival rates between Indigenous and non-Indigenous patients.⁴

Culturally-appropriate care: Interactions with healthcare providers should incorporate cultural safety and cultural competency. Indigenous Navigator are present in hospitals to provide support to and advocate for Indigenous patients. This can include addressing spiritual needs and coordinating access to culturally-safe supportive care.

What does breast cancer screening involve? Breast cancer screening refers to mammograms, clinical examinations, and breast-self examination. Mammograms are recommended for women between the ages of 50-74 once every 2 years. However, routine mammograms are not recommended for women between the ages of 40 to 49, although patients at high risk should speak to a physician about screening.⁵ Since 2003, there have been signs of improvement, with increased rates of breast cancer screening in First Nations populations and 30% of First Nations women reporting performing breast-self examinations on a monthly basis.⁵

Supports

General

Canada Wide

Yukon

Northwest Territories

Nunavut & Nunavik

British Columbia

Alberta

Saskatchewan

Manitoba

Ontario

Quebec

New Brunswick

Nova Scotia

Prince Edward Island

Newfoundland & Labrador

Author  | Mathura Thiyagarajah

References

1. Ahmed, S., Shahid, R. K., & Episkenew, J. A. (2015). Disparity in cancer prevention and screening in aboriginal populations: recommendations for action. Current Oncology, 22(6), 417.
2. Decker, K. M., Kliewer, E. V., Demers, A. A., Fradette, K., Biswanger, N., Musto, G., … & Turner, D. (2016). Cancer incidence, mortality, and stage at diagnosis in First Nations living in Manitoba. Current Oncology, 23(4), 225.
3. Sheppard, A. J., Chiarelli, A. M., Marrett, L. D., Mirea, L., Nishri, E. D., Trudeau, M. E., … & Madarnas, Y. (2010). Detection of later stage breast cancer in First Nations women in Ontario, Canada. Canadian journal of public health, 101(1), 101-105.
4. Withrow, D. R., Pole, J. D., Nishri, E. D., Tjepkema, M., & Marrett, L. D. (2017). Cancer survival disparities between First Nation and non-Aboriginal adults in Canada: follow-up of the 1991 census mortality cohort. Cancer Epidemiology and Prevention Biomarkers, 26(1), 145-151.
5. Canadian Partnership Against Cancer. (2013). First Nations Cancer Control in Canada Baseline Report. Canadian Partnership Against Cancer.