2022-23 Annual report

A journey of change for First Nations, Inuit and Métis cancer care

Improving cancer care and outcomes for and with First Nations, Inuit and Métis peoples in Canada is intrinsic to the vision of the Canadian Strategy for Cancer Control.

Meaningful change takes time, and the process demands ongoing commitment and collaboration. By actively listening to, learning from and working together with First Nations, Inuit and Métis organizations and governments, progress can be made on self-determined priorities.

By providing better access to screening, treatment and support services, as well as training healthcare professionals to understand and respect First Nations, Inuit and Métis ways of knowing, partners can support First Nations, Inuit and Métis to improve cancer care and outcomes and achieve health equity for all.

Examples of partners’ achievements

Colorectal screening in the Northwest Territories

Collaborating closely with First Nations, Inuit and Métis governments, local healthcare providers and others, the Northwest Territories Health and Social Services Authority developed and implemented the first-ever organized colorectal cancer screening program in six of the territory’s seven health regions, and part of the seventh.

The program used learnings from a pilot project in the territory’s Beaufort Delta region. Beaufort Delta, which is home to eight Inuvialuit and Gwich’in First Nations communities, historically had the lowest colorectal cancer screening rate in the territory. In 2017–19, only 12.5% of people were screened – and only 6% in some rural and remote areas.

Using virtual engagement and a community awareness campaign during the pandemic, followed by a return to in-person treatment more recently, the partners ensured a culturally appropriate, respectful and community-centred approach to cancer screening.

The program’s expansion across the territory has improved access to screening, resulted in higher screening rates and dramatically improved outcomes for residents. Stage 4 diagnoses, where advanced cancer is present, have significantly decreased. More people now are being diagnosed at stage 0, which is considered pre-cancerous.

Removing barriers to care

Travelling to medical appointments for cancer care can be a major barrier for Métis people who live in rural and remote areas far from cancer centres and cannot get the care they need close to home.

The Métis Nation–Saskatchewan Travel Assistance Pilot Program is improving outcomes for Métis people with cancer by offering support such as reimbursement of fuel costs and accommodation, and a healthy food allowance.

Improving the cancer system collaboratively and respectfully

The Partnership signed a relationship agreement with the First Nations Health Managers Association for the two organizations to work respectfully and reciprocally together to improve cancer care and health outcomes for and with First Nations across Canada.

The agreement outlines three areas of respectful collaboration between these two partners:

• Information sharing and capacity development will develop and deliver information, knowledge, training and development services that benefit the people served by both organizations.
• Health system initiatives will enhance relationships between First Nations communities and provincial/territorial cancer systems to foster cultural safety and humility in cancer service delivery.
• Health leadership initiatives will support the continued development of leaders in First Nations health and foster shared learnings of cancer system leaders across Canada.

The agreement provides the foundation for how we will work together in a positive and productive manner. It recognizes the important role that each organization plays in improving the cancer system with and for First Nations peoples, and acknowledges the importance of doing so while respecting and including First Nations’ values and ways of knowing.

Becoming better partners

The Partnership worked through the year to do more to support First Nations, Inuit and Métis partners in their self-determined initiatives to improve First Nations, Inuit and Metis-governed research and data.

• A working group identified indicators that will help in reporting on progress and driving changes toward the Strategy’s priorities, including culturally appropriate care closer to home, Peoples-specific, self-determined care and First Nations, Inuit and Métis-governed research and data systems. 
• The Partnership supported work at the University of British Columbia (UBC) to develop a First Nations component to the Northern Biobank initiative, which will help rural, remote and First Nations residents living in northern BC participate in genomic research and realize the benefits of better representation in such work. First Nations communities in British Columbia recognize the importance of genomic research in addressing disparities in cancer outcomes. The Northern BC First Nations Biobank will be directed, governed and led by First Nations in northern BC with support from the Northern Biobank team at UBC.
• Partnership staff completed The Fundamentals of OCAP® (ownership, control, access and possession) course, offered by the First Nations Information Governance Centre, which enabled us to better understand principles of First Nations data governance.

Staying connected

The Partnership supported close connections among partners by hosting knowledge sharing workshops where we could share successes and challenges and discuss how to build sustainability within and beyond the projects. In March, more than 80 partners representing the 29 First Nations, Inuit and Métis partner organizations gathered in Toronto for the final knowledge sharing event to share and learn from each other’s work, and to mark the conclusion of the Partnership-funded initiative to support improved cancer outcomes in First Nations, Inuit and Métis communities.