Abstract

Cancer screening is an important component of a cancer control strategy. Indigenous people in Canada have higher incidence rates for many types of cancer, including those that can be detected early or prevented through organized screening programs. Increased participation and retention in cancer screening is critical to improved population health outcomes amongst Indigenous people. This rapid review evaluates cancer screening interventions published in the last six years. Included studies demonstrated increased participation in breast, colorectal, or cervical cancer screening programs in Indigenous populations or showed promise of increased participation based on the factors that influence people’s screening practices, such as knowledge, attitude, or intent to screen. The Preferred Reporting Items for Systematic Reviews guided the search strategy. The review identified 85 articles with 12 meeting the specified criteria: seven studies reported an increase in cancer screening participation and five studies reported improved knowledge, attitude, or intent to screen. The use of multiple culturally appropriate strategies in co-designed studies were the most effective. This review will be used to inform First Nations (FN) populations and Screening Programs in Alberta of potential strategies to address disparities identified through a recent data analysis comparing cancer screening and outcomes between FN and non-FN people.

Highlights

  • A review by Hutchinson et al (2018) identified the following barriers to cancer screening among Indigenous people living in Canada: (1) Attitudes and beliefs about cancer; (2) Health system challenges; (3) Lack of trusting relationships with health care providers and health organizations; (4) Lack of knowledge or awareness about cancer and cancer screening; (5) Barriers associated with demographics and health determinants; (6) Impacts of colonialism, discrimination, and/or racism

  • Participants were recruited from three southwestern United States tribal health care facilities and randomly assigned to one of three study groups, including: (1) usual care, (2) FIT kit mailing, (3) FIT kit mailing with follow-up outreach by phone and/or home visit from an American Indian Community Health Representative (CHR) if the completed kit was not returned within four weeks of mailing

  • This review began with no a priori assumptions about the importance of intervention factors, with the exception of respectful engagement with Indigenous community leaders

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Summary

Disparities in Cancer Screening Among Indigenous Populations

Cancer is the third most common cause of death among First Nations (FN) people living in Alberta. In 2015, total cancer screening rates were higher for all of Alberta compared to its rural and remote North Zone for breast (56.7% vs 48.7%), cervical (62% vs 56.9%), and colorectal (39.2% vs 36.1%) cancer screening [5]. To better understand the screening practices of FN people in Alberta’s three provincial cancer screening programs (breast, cervical, colorectal), a recent study assessed cancer screening utilization and outcomes among FN people in Alberta in partnership with the Alberta First Nations Information Governance Centre (AFNIGC). This research identified disparities in all three screening programs but was not designed to explore the reasons or solutions for these disparities The purpose of this rapid review was to inform future co-planning by FN communities and Screening Programs through the identification of effective and feasible cancer screening interventions that may address disparities in cancer screening participation among FN people in Alberta and beyond

Increasing Cancer Screening in Indigenous Populations
Methods
Search Strategy
Selection Strategy
Study Design & Intervention
Text-Message Reminders
Telephone Call Reminders
HPV Self-Sampling
Mailing of FIT Kits
Opportunistic Screening Pilot
Translational Research
Peer-Led Intervention
Multicomponent Intervention
Preference and Acceptability of HPV Self-Sampling
Conclusions
Communication Methods
Findings
Design Screening Types
Full Text
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