Métis people in Ontario are at greater risk for a number of cancers

By Margaret Froh, President of the Métis Nation of Ontario

After a routine mammogram in early June, it was discovered that I have a form of breast cancer known invasive ductal carcinoma. Unfortunately, Métis people in Ontario not only experience higher incidences of cancer than the non-Indigenous population, but we also undergo regular cancer screenings at a much lower rate.

October is Breast Cancer Awareness month, and while we celebrate the remarkable progress that has been made against breast cancer, 1-in-8 women in Canada are expected to be diagnosed with breast cancer in their lifetime. According to the Canadian Cancer Society, 2-in-5 Canadians will be diagnosed with some form of cancer in their lifetimes. In the Métis community, there are higher rates of cancer compared to non-Indigenous adults, and Métis women are well-below the national target screening rates for routine mammograms.

In a report the Métis Nation of Ontario (MNO) published in 2015 in partnership with Cancer Care Ontario, we found that less than half of Métis women aged 50-74 have had a recent mammogram, compared to almost two-thirds of the general population, and half of Métis adults aged 50 to 74 needed a screening test for colorectal cancer because they have not had a recent blood test, sigmoidoscopy or colonoscopy.

This has been compounded by COVID-19. The Ontario Medical Association (OMA) recently said that 400,000 fewer mammograms were performed in the province during the pandemic. As a result, Ontario doctors have been seeing more advanced cases of breast cancer. While screenings have since returned to normal levels, the OMA warned that the temporary decrease in testing has led to many cancer cases being diagnosed at later, and more complicated, stages.

In Ontario, the evidence of chronic disease rates among Métis populations are disproportionately higher, paired with lower access to primary and specialist care than non-Indigenous populations. A study published in 2018 examined incidence rates and survival for the most common cancers among Métis adults in Canada and compared these with rates for non-Indigenous adults from 1992 to 2009.

Findings showed that the incidence of breast cancer and cervical cancer was significantly higher among Métis women compared to non-Indigenous women. Lung, liver, larynx, and gallbladder cancers were also higher among Métis adults, and Métis men had significantly poorer survival rates for prostate cancer compared to non-Indigenous men.

Over the past several years, MNO has been working closely with partners to increase our shared understanding of cancer in Métis populations and develop targeted resources and interventions to help reduce cancer rates. Building on our research, the MNO, Cancer Care Ontario, and Sunnybrook Research Institute partnered on a community-based study that examined factors impacting cancer screening among Métis in Ontario.

Our findings were released in September 2021, recommending more support for cancer screening awareness and front-line MNO workers facilitating cancer screening uptake in Métis communities; improved supports for health-care providers to engage more effectively with Métis patients; and policy and program development to promote cancer screening knowledge and uptake in Métis communities.

Thanks to an early screening, the prognosis in my case is very good. I have undergone surgery and four of eight rounds of chemotherapy already. I am thankful to have caught this early with a routine mammogram and feel very fortunate to have had access to cancer screening services. Unlike many Métis, I am fortunate to live in an area with access to solid primary health care and have access to cancer treatment in the community where I live.

But it’s clear that Métis people in Ontario are at greater risk for a number of cancers and are under-screened, leading them to suffer disproportionately. More work needs to be done to improve cancer screening and outcomes among the Métis, as this disease impacts our families and communities deeply.

I encourage all Ontarians to book cancer-screening appointments, and to do so regularly, especially if you are over 50. For the Métis, this is even more critical. Our culture is one of thriving, vibrant communities, and that depends on good health and well-being.

This op-ed ran in the Toronto Star on October 22, 2022.