Taking the critical test
New study to look at low cancer screening rates
Kassina Ryder
Northern News Services
Published Monday, March 31, 2014
NORTHWEST TERRITORIES
Few residents in the territory's smaller communities are being screened for cancer and a new study launching this year aims to find out why.
Ninety per cent of colorectal cancer cases are curable when found early, but a study recently published by the Department of Health and Social Services found half of all cases in the territory are only diagnosed after the cancer has reached stages three or four when the survival rates are considerably lower.
Only 20 per cent of the age group recommended for testing, ages 50 to 74, was screened for colorectal cancer in 2011 and 2012.
It's the second-most common cause of cancer related death after lung cancer in the territory, the report also stated.
Wilfred McNeely Jr., former chief of Fort Good Hope, said he believes fear could be keeping people from getting tested.
"I think it's afraid of being checked," he said. "They're worried about what they're going to do when they find out the results."
Sangita Sharma, a professor at the University of Alberta and chair of the Aboriginal and Global Health Research Group, is partnering with the territorial health department to take a closer look at the NWT's cancer screening rates. Alberta Innovates Health Solutions is funding the project.
The health department's report, titled Cancer in the Northwest Territories 2001-2010 and tabled in the legislative assembly on March 6, found cancer screening rates in the territory's small communities were lower than the Canadian average.
Only 12 per cent of people in small communities eligible for colorectal cancer screening were tested in 2011-2012, the report stated.
The Canadian average was 32 per cent, according to the Canadian Cancer Society.
The report also found testing rates are higher in Yellowknife compared to small communities. Forty-two per cent of eligible women in small communities received the cervical cancer screening Papanicolaou test (Pap test), in 2011 and 2012 compared to 61 per cent in Yellowknife.
The most common cancers in the territory are lung, colorectal, breast and prostate cancer.
Sharma said the study aims to identify reasons why people in smaller communities aren't getting tested as often as those in larger centres.
She said finding cancer in stages one or two can drastically increase the chances of beating the disease.
"If you don't know, then by the time you get diagnosed it could be too late," she said. "As soon as you start the prevention and the treatment, the better the prognosis."
Sharma said her team has already begun the groundwork for the study and plan to interview residents in two communities about their cancer screening histories this fall.
Sharma said local staff will help gather the data, which will then be used to identify reasons why people aren't being screened and ways to improve.
"We present the results to the communities and then see what the communities actually want, what they thought were the best solutions to address whatever issues we find," she said.
She said the ultimate goal is to help guide policy makers developing cancer-screening programs and services for Northerners.
Sabrina Broadhead, director for aboriginal health and community wellness with the NWT Department of Health and Social Services, said mammograms to check for breast cancer are available in larger centres that have mammography machines, such as Yellowknife and Inuvik. But Pap tests for cervical cancer and fecal immunochemical tests (FIT tests) for colorectal cancer are available at all health centres.
"There are three types of screening that are available in the NWT: breast, colorectal and cervical cancer," she said.
"The Pap test for cervical cancer and colorectal cancer are available in all the communities in the NWT."
Broadhead said Pap tests should be done every two years starting at age 21.
"A lot of people make assumptions that cancer is only something you test for as you get older," she said. "Cervical cancer is one you should start when you're younger."
Screening for breast cancer and colorectal cancer should begin around age 50 and occur every two years, Broadhead said.
FIT testing for colorectal cancer can even be done at home, she said.
Stool samples taken at home are then sent to a lab for testing.
She said even though colorectal cancer testing is available and easy, screening rates are still low.
"Colorectal cancer has the least uptake in screening at this point," she said.
"We need to increase awareness about where the test is and how people can do the test at home and the difference it can make."
Broadhead said so far, the department assisted the research team to develop questions for surveys and helped facilitated a partnership with Fort Good Hope.
Interviews are scheduled to begin in the fall, Sharma said.
Once finished, the information could be used to help other jurisdictions facing similar challenges, such as in Northern Alberta or the other territories, she said.
In the meantime, Sharma said interviewing people in the NWT will help identify solutions locally.
"The idea is to address things we can then improve," she said.
McNeely Jr. said he encouraged residents to take advantage of yearly physicals and screening programs offered in communities.
"It's treatable if you catch it early enough," he said.
