A retrospective review of cancer treatments and outcomes among inuit referred from Nunavut, Canada

Abstract

Background Cancer is a health concern in Inuit populations. Unique cultural, dietary, and geneticfactors andgeographic isolation influence cancer epidemiology in this group. Inuit-specificdata about oncology treatments andsurvival outcomes in Canadian Inuit referred to urban treatment centres are lacking.Methods A retrospective chart review of Inuit patients referred to The Ottawa Hospital Cancer Centre (TOHCC)from the Baffin region of Nunavut between 2000 and 2010was conducted. Nunavut cancer registry data were usedto establish the percentage of cancer cases referred and their survival outcomes.Results Of 307 cancer patients registered among Baffinregion Inuit, 216 [70% (63 men, 153 women)] were referred totohcc for chemotherapy (CT) and radiation therapy (RT). Mean age in the referred group was 59.3 years (range: 25–89years), and current smokers constituted half the group (52%). The cancers most commonly leading to referrainmenwere lung (55%), colorectal (19%), and nasopharyngeal (11%) cancers; in women,they were lung (46%), colorectal(24%), breast (10%), nasopharyngeal (6%), and cervical(5%) cancers. Of the 216 referred patients, 82 (38%) hadalready undergone surgery, and 18 (8%) received chemoradiation or rt only, all given with curative intent. Amongthe surgical patients referred, 33 (40%) and 23 (28%) went on to receive adjuvant ct and adjuvant rt respectively.Among 116 patients referred for palliative care, 64 (55%) received ct, 76 (66%)received rt, 43 (37%) received both ctand rt, and 19 (16%) received neither treatment. Median all-stage overall survival was 10 months for patients withlung cancer [95% confidence interval: 6.1 to 13.9 months] and 37 months for patients with colorectal cancer [95%confidence interval: 14.8 to 59.2 months].Conclusions High uptake of palliative and adjuvant ct and rt was observed in the Inuit patients referred to tohcc.Lung cancer was the most common cancer in referred Inuit men and women. The survival rates for Inuit lung cancerpatients referred to tohcc were comparable to those in the rest of Canada. Further research is required to understand reasons for non-referral of Canadian Inuit to TOHCC.