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Letendre A, Shewchuk B, Healy BA, Chiang B, Bill L, Newsome J, Rahul CR, Yang H, Kopciuk KA. Assessing Breast Cancer Screening and Outcomes Among First Nations Women in Alberta. Cancer Control 2024; 31:10732748241230763. [PMID: 38299564 PMCID: PMC10836128 DOI: 10.1177/10732748241230763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Breast cancer (BC) incidence rates for First Nations (FN) women in Canada have been steadily increasing and are often diagnosed at a later stage. Despite efforts to expand the reach of BC screening programs for FN populations in Alberta (AB), gaps in screening and outcomes exist. METHODS Existing population-based administrative databases including the AB BC Screening Program, the AB Cancer Registry, and an AB-specific FN registry data were linked to evaluate BC screening participation, detection, and timeliness of outcomes in this retrospective study. Tests of proportions and trends compared the findings between FN and non-FN women, aged 50-74 years, beginning in 2008. Incorporation of FN principles of ownership, control, access, and possession (OCAP®) managed respectful sharing and utilization of FN data and findings. RESULTS The average age-standardized participation (2013-8) and retention rates (2015-6) for FN women compared to non-FN women in AB were 23.8% (P < .0001) and 10.3% (P = .059) lower per year, respectively. FN women were diagnosed with an invasive cancer more often in Stage II (P-value = .02). Following 90% completion of diagnostic assessments, it took 2-4 weeks longer for FN women to receive their first diagnosis as well as definitive diagnoses than non-FN women. CONCLUSION Collectively, these findings suggest that access to and provision of screening services for FN women may not be equitable and may contribute to higher BC incidence and mortality rates. Collaborations between FN groups and screening programs are needed to eliminate these inequities to prevent more cancers in FN women.
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Affiliation(s)
- Angeline Letendre
- Public Health Evidence & Innovation, Provincial, Population and Public Health, Alberta Health Services, Edmonton, AB, Canada
| | - Brittany Shewchuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Bonnie A Healy
- Siksikaitsitapi - Blackfoot Confederacy Tribal Council, Calgary, AB, Canada
| | - Bonnie Chiang
- Screening Programs, Provincial Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - Lea Bill
- Alberta First Nations Information Governance Centre, Calgary, AB, Canada
| | - James Newsome
- Screening Programs, Provincial Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - Chinmoy Roy Rahul
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB, Canada
| | - Huiming Yang
- Screening Programs, Provincial Population and Public Health, Alberta Health Services, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Karen A Kopciuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Oncology, University of Calgary, Calgary, AB, Canada
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