More resources needed for First Nations cancer screening, treatment: report

SIOUX LOOKOUT — People living in Indigenous communities across a vast swath of Northwestern Ontario are more at risk of dying from certain cancers, in large part due to a lack of resources for close-to-home screening and treatment.

That’s one conclusion drawn by a new peer-reviewed study released by the Sioux Lookout First Nations Health Authority. The organization serves 33 First Nations, most of which are remote, across Northwestern Ontario. It provides things like primary care, counselling, accommodations, transportation and other services, according to its website.

“We (hear) from communities quite often that people have cancer and they get a late diagnosis, and then they pass away before treatment can be provided,” said Janet Gordon, the health authority’s vice president of community health. “We wanted to know what that picture looked like.”

Two of the report’s key findings highlighted in a media release said that five-year cancer survival rates across the First Nations health authority’s catchment area are 14.5 per cent lower than the Ontario average, and that systemic barriers — such as unreliable transportation to necessary out-of-community facilities, “rigid federal travel policies,” a lack of trust in the mainstream healthcare system and a lack of facilities that prioritize being culturally safe — all result in late diagnoses and treatment that is inadequate.

Gordon said, particularly in remote communities that rely on a local nursing station, the facilities can be too understaffed — and First Nations can lack enough accommodation for specialists to be there — or otherwise under-resourced to provide these screenings and other early intervention close to home. That means travelling, sometimes hundreds of kilometres away, and navigating a “cumbersome system,” she added.

“Sometimes people will miss their appointments because they get told at the last minute they have an appointment, or they don’t get told at all, so they miss their appointments for those specialists or those tests that need to be done outside of their community,” Gordon said.

Overall, the report found that age-standardized data revealed higher risks for specific cancers, including colorectal, kidney, lung, prostate and cervical cancers in the health authority’s communities. It also noted that screening rates are significantly lower across its catchment area, particularly for breast and cervical cancer. 

The report makes a number of recommendations, including significantly bettering on-reserve infrastructure like diagnostic services and culturally-appropriate health facilities, training and hiring more Indigenous health care professionals and expanding the roles in-community health representatives can fill, providing more funding for mobile screening services and that local First Nations health stakeholders, in partnership with senior levels of government, establish a specific Indigenous-led 10-year cancer strategy.

“Listening to First Nations people whose lives have been touched by cancer challenges decision makers and healthcare professionals to reflect and reinterpret healthcare systems, policies, and services,” the report said.

“Remoteness factors, systemic barriers and discrimination, and poor social determinants of health experienced by First Nations people in the region underpins the urgent need for a (holistic) and multi-faceted approach in cancer care.”

“We need resources to do that, to close the gap,” Gordon said. “You actually need people that can do that.” 

“I think communities will have solutions, and so we need to work with communities to develop that strategy at the community level in terms of screening, in terms of health education that needs to happen.”

And getting those resources, like funding and people, to the First Nations themselves is paramount, she said.

“We certainly have been doing some public health, but we need way more resources than we have to be able to make a difference in people’s well-being,” Gordon said.

“There’s challenges around infrastructure, challenges with recruitment and retention, and just challenges, I think, (around) the resources that are available at the community level.”