Cancer incidence, stage at diagnosis and outcomes among Manitoba First Nations people living on and off reserve: a retrospective population-based analysis

Tara C. Horrill; Lindsey Dahl; Esther Sanderson; Garry Munro; Cindy Garson; Randy Fransoo; Genevieve Thompson; Catherine Cook; Janice Linton; Annette S.H. Schultz

doi:10.9778/cmajo.20190176

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Focus on disease that can be changed
James A Dickinson

Posted on: 20 December 2019

Posted on: (20 December 2019)
Page navigation anchor for Focus on disease that can be changed
Focus on disease that can be changed
James A Dickinson, Professor of Family Medicine
Horrill et al demonstrate differences in cancer incidence that might be due to deficits in care for First Nations people on reserve. However the overall cancer mortality is not significantly different between those on or off reserve. It might be different from the general population of Manitoba, and it is a pity that the authors did not provide such a comparison. Since many cancers can neither be screened for nor effecti...
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Horrill et al demonstrate differences in cancer incidence that might be due to deficits in care for First Nations people on reserve. However the overall cancer mortality is not significantly different between those on or off reserve. It might be different from the general population of Manitoba, and it is a pity that the authors did not provide such a comparison. Since many cancers can neither be screened for nor effectively treated, they are not amenable to better medical care. A difference might be observed if analysis were restricted to those cancers where medical care can reasonably be expected to affect outcomes.
The authors state that cervical screening on reserve is limited, because care is largely provided by nurses who are not trained to perform cervical screening. This is unfortunate, since such screening can make a difference to outcome for cervical cancer, and nurses can learn to perform screening very competently. In the UK, nearly all cervical screening is performed by nurses. Why does this not occur in Manitoba?
Conflict of Interest:
None declared
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Competing Interests: None declared.