Investigating kidney cancer outcomes among First Nations adults in Canada, 2006-2015 Followup of the 2006 Canadian Census Health and Environmental Cohort.

Abstract

Introduction: Where reported at a regional level, kidney cancer incidence and mortality rates are disproportionately higher among First Nations people compared to the non-Indigenous population in Canada; however, national-scale reporting has been limited. This study aimed to examine kidney cancer outcomes among First Nations compared to non-Indigenous adults in Canada from 2006-2015.

Methods: Data were from the 2006 Canadian Census Health and Environmental Cohort (CanCHEC), which linked census respondents to national cancer and mortality databases. Age-standardized incidence and mortality rates were calculated using the 1960 World Standard Population and stratified by sex, age, and region. Relative risks were estimated using Poisson regression.

Results: First Nations adults were diagnosed with 445 kidney cancer cases from 2006-2015 and had nearly twice the incidence rate of kidney cancer compared to non-Indigenous adults (relative risk [RR] 1.99, 95% confidence interval [CI] 1.68-2.35). Incidence rates were also elevated by sex, across age groups, and within certain regions. Mortality rates were higher among First Nations adults across all categories, including all-cause, cancer-specific, and kidney cancer mortality, in both sexes and overall.

Conclusions: These findings support concerns raised by First Nations partners about rising kidney cancer incidence and mortality. Interventions targeting risk factors, improved chronic disease management, and access to care are needed. Consistent national data, including stage information, would support better surveillance, early detection, and equitable cancer outcomes.