Whitehorse Daily Star

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Dr. Brendan Hanley

Yukon’s cancer data parallel the nation’s

A cancer incidence report released by the Yukon government has found the territory to be in step with the rest of Canada regarding cancer numbers,

By Gabrielle Plonka on August 5, 2019

A cancer incidence report released by the Yukon government has found the territory to be in step with the rest of Canada regarding cancer numbers, but predicts that the number of people diagnosed with cancer will increase as the Yukon’s population ages and grows.

“Cancer is the leading cause of death in Yukon, and one of the top health concerns among Yukon First Nations,” Dr. Brendan Hanley, the Yukon’s chief medical officer, says in a forward to the report.

“It makes sense, therefore, that we probe, ask questions and do our best to understand as much as we can about cancer in the Yukon.”

The 67-page report was issued Friday afternoon. It outlines trends in cancer incidence, or the rate of new cases of cancer, between 2009 and 2016.

The investigation, led by Hanley, intends to inform decisions about the future of cancer control and made recommendations for improvement to procedures.

“(In the Yukon) even more than elsewhere, we are acutely aware that each statistic, each new case, represents someone that is one of us: someone that could be family, or from our neighbourhood, a colleague or teammate or acquaintance,” he says in the report.

The report found 153 new cancer cases were diagnosed annually in the seven years between 2009 and 2016. This found a total of 1,225 new cases over the entire period. The number of cancer incidences have fallen since 2009, and are at similar levels as Canadian rates, researchers found. 

Four cancers comprised 55 per cent of all cases diagnosed. The most common cancer in the Yukon was found to be breast cancer; followed by lung, colorectal and prostate cancers.

These four cancers are also the most common causes of cancer deaths in the Yukon and across Canada. 

The Yukon’s female breast cancer rates are “significantly elevated” compared to the rest of Canada and are increasing slightly. Thirty-five per cent of women diagnosed were found to have breast cancer. 

However, nearly three-quarters of breast cancer incidences in the territory are caught at an early stage. To maintain early detection rates, the report says, organized breast cancer screening programs, widespread awareness of symptoms and prompt access to care are necessary.

For women aged 50 to 74, routine screening for breast cancer is recommended every two to three years.

Prostate cancer was the most commonly diagnosed among males, at 23 per cent or 18 new cases annually. These rates are lower than the national average and half of these cases were found at an early stage.

There was an average of 19 new cases of colorectal cancer annually, and these were similarly diagnosed at an early stage about half of the time.

Adults aged 50 to 74 years of age are recommended to undergo a fecal occult blood test every two years, or flexible sigmoidoscopy every 10 years.

A colonoscopy is not a recommended screening test for colorectal cancer.

The report says increasing participation will help shift diagnosis to “early and/or treatable stages.”

Lung cancer rates have declined in the Yukon. However, lung cancer is still the leading cause of cancer deaths.

Between 1999 and 2013, lung cancer accounted for 30 per cent of cancer deaths in the Yukon.

This is, in part, because about half of the incidences were detected at Stage IV, when cancer has already spread beyond the lungs, a statistic that is true across Canada.

Pilot studies are underway to develop the feasibility of a screening program, as there currently isn’t one for lung cancer.

Currently, high-risk individuals – defined as those who have “a smoking history of 30 pack-years,” currently smoke or quit fewer than 15 years ago – aged 55-74 years are recommended for screening annually. Screening is not recommended for all other adults.

Smoking is an important risk factor leading to lung cancer. The report stated that nearly a quarter of Yukoners self-report as daily or occasional smokers. This is eight per cent higher than the Canadian national average estimate. 

Other commonly diagnosed cancers in Yukon are bladder, cervical, endometrial, melanoma, Non-Hodgkin’s lymphoma, leukemia and stomach cancers.

“Some cancers are more amenable to early diagnosis,” Hanley told the Star this morning.

“So (we need to) make sure we have good awareness of what those are, for the most common cancers, so people know to take certain symptoms seriously.”

Six per cent more Yukon males than females were diagnosed with cancer, and approximately 87 per cent of people diagnosed were aged 50 or older.

The report found that cancer rates were slightly higher for Yukoners living outside of Whitehorse.

While the number of cancer cases have diminished, the report warns of a future rise, due to an expected population increase and the Yukon’s large aging population. 

“It’s important to distinguish although we’re seeing declining rates of cancer, we’re seeing increasing numbers,” Hanley said this morning. 

The Yukon Bureau of Statistics expects the territory’s population to increase 1.6 per cent to 49,040 by 2030. Additionally, the territory is seeing an increase in populations aged 65 and over. 

“Population aging and growth have important health implications,” the report said. 

“As the population ages, we can expect a greater number of individuals developing diseases that are strongly linked with age, like cancer.”

The investigation noted that the expected rise will create “an increasing demand on health and social services in the territory.”

The report made five recommendations to prepare for the increase:

  1. establish a Yukon Cancer Steering Committee to oversee a co-ordinated approach to cancer prevention and control involving the Government of Yukon and Yukon First Nations;

  2. partner with Yukon First Nations governments and communities for meaningful reporting of cancer data; 

  3. report on key indicators of cancer care to inform and improve cancer care pathways in Yukon; 

  4. build on existing initiatives that target modifiable risk factors, the social determinants of health and climate change to help prevent cancer; and 

  5. develop a centralized cancer screening hub to facilitate and evaluate organized cancer screening programs that improve early detection, reduce cancer mortality and improve survival.

According to Hanley, these recommendations aim to increase awareness activities that will enable cancer prevention through education and maintaining good early diagnosis rates, as well as building a partnership with “external governments such as a meaningful First Nations voice.”

Alongside this, Hanley hopes to improve the efficiency of treatment processes like wait times and the available range of therapies. The report itself, he says, is a good first step, as it’s a step above research done in previous years.

“I think we overall have very good care here,” Hanley said. “I think it’s important to look ahead, to get ahead of the curve.

“This is about people, and it’s about the quality of life for Yukon citizens.”

Comments (5)

Up 1 Down 0

Simon on Aug 8, 2019 at 2:55 pm

Simon,
The term "open" is clearly defined at https://open.yukon.ca/data/about. Here is some of that text, copied and pasted:

"We will include open data that can be freely accessed, used, shared and built-on by anyone, anywhere, and for any purpose. We will not include data that:

- contains personally identifiable information;
- poses any legal, security, confidentiality, privacy or commercial sensitivity, and other concerns that may prevent data sets from being shared with the public;
is outdated and incorrect; or
- includes only information such as press releases, books, brochures, thesis etc."

In other words, no personal interpretation or spin allowed; let data be data and let it be free for use so anyone can develop their own opinions about it.

"Open" shouldn't be defined by the government in power.
The public is a lot smarter than you think and give them credit in your response.

Up 2 Down 0

Gabrielle Plonka on Aug 8, 2019 at 9:35 am

You can find the report here: https://yukon.ca/en/news/yukons-chief-medical-officer-health-releases-cancer-incidence-report

Up 2 Down 1

Seth Wright on Aug 7, 2019 at 7:33 pm

Dear Simon - Each government has their own operational definition of key words such as “open”. These definitions are not written down anywhere as they remain fluid and situational and therefore would only serve to confuse the public. Those that govern have a tacit understanding of how these definitions are applied to a given set of circumstances... Transparent you say?

Up 8 Down 6

Thomas Brewer on Aug 5, 2019 at 3:19 pm

Bet you a dollar that Hanley wants to chair the new "Yukon Cancer Steering Committee" for another ridiculously expensive contract...

Up 10 Down 0

Simon on Aug 5, 2019 at 3:16 pm

Why is this report and the data not on the government's new open data website? When I search for "cancer" it doesn't come up https://open.yukon.ca/data/search?query=cancer

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