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Colorectal cancer rates in the Aboriginal population are rising at a higher rate than the Canadian average. According to Cancer Care Ontario, unless preventative measures are taken, colorectal cancer rates among Aboriginal Peoples will soon surpass those in the general population. Like Type 2 diabetes, this is a disease that people can do a lot about.
To learn more we met Alvin F. from a First Nations community in Northern Ontario.
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When I heard that my father had colorectal cancer, I had lots of questions. I had never heard of this type of cancer. My father was the first case to be diagnosed in our community. I wanted to know what caused this colorectal cancer. Am I going to get it too? |
Did you know?
"Changing my eating habits was just as hard as stopping smoking."
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- Colorectal cancer is the fourth most common cancer for both men and women in Canada in 2006.
- It is the second most frequent cause of cancer deaths for Canadians - only lung cancer takes more lives.
- Colorectal cancer responds best to treatment when it is found and treated as early as possible.
Source: Canadian Cancer Society
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What is colorectal cancer?
Colorectal cancer starts in the colon and the rectum, the two parts of the lower intestine that process and discharge solid waste from our bodies.
Who is at risk?
- If you are over 50, you are more likely to get colorectal cancer, and the risk increases as you get older. Men are more at risk than women. A family history of the disease also increases your likelihood of getting colorectal cancer as does living with inflammatory bowel disease (ulcerative colitis or Crohn's disease) and polyps - small growths on the inner wall of the colon and rectum. These are risk factors that you can't change.
- Some risk
factors that you can do something about include your diet, alcohol
use, tobacco use, obesity, and physical inactivity.
Screening and detection
Over half of all cases could be prevented through lifestyle changes and early screening. The signs and symptoms of colorectal cancer may not appear for a long time. That is why screening is so important. Screening can also reduce the likelihood of being diagnosed with colorectal cancer by finding and removing polyps before they develop into cancer.
Manitoba will be the first province to distribute 20,000 screening kits this spring for people over 50 in the Winnipeg and Assiniboine health regions. Starting next year, Ontarians over 50 will also be able to pick up home screening kits from their family doctors or pharmacists. By identifying those who should receive a colonoscopy examination, the program will save thousands of lives a year.
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My father's treatment is going well. According to his doctor, many people can be successfully treated if colorectal cancer is caught in its earliest stage. I may not inherit the disease, but I am still at risk because I weigh too much. |
Alarming rise in colorectal cancer in Aboriginal Peoples
From comparative studies in Ontario, which has the largest Aboriginal population in Canada, First Nations people have a lower reported rate of cancer than the general population of Ontario.
Years ago, only the rates for cervix and gallbladder cancers were higher in First Nations people. And in the 1970s and 1980s, the rates for colorectal cancer were much lower among First Nations than among the general population. Unfortunately, these rates have risen rapidly - much more so than in the general population - and are now about the same.
Why are rates increasing among Aboriginal Peoples?
The most likely theory is that this increase is due to changes in Aboriginal Peoples' lifestyle and diet - poorer diet, less physical activity, and more obesity. These same changes are also probably responsible for the rising rates of diabetes and metabolic syndrome (a combination of three or more health risks) among Aboriginal Peoples, which further increase their risk of colorectal cancer.
- Eating habits have changed
People who are overweight are at greater risk for colorectal cancer (as well as some other types of cancer) and other health problems such as diabetes, heart disease and stroke. According to a recent study on Overweight and Obesity in Canada, Aboriginal Peoples have, on average, higher rates of obesity than non-Aboriginal people. This is also the trend among other Canadian populations with less education, lower incomes, as well as people who live in rural areas.
The lifestyle of Aboriginal Peoples has changed a lot over a very short period, and not always by the choice of Aboriginal Peoples. For example, more than 50% of Aboriginal Peoples in Canada now live in urban centres, which mean they are not often able to get the foods that made up their traditional diet. Also, Aboriginal people living on reserves may have limited access to fish and game such as caribou. Those living in the North face much higher prices for healthy foods such a fruits and vegetables, which are grown thousands of miles away.
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It only makes sense that a disease that originates in the gut is related to my diet. But changing my eating habits was just as hard as stopping smoking. I'm taking many little steps. My wife and I started watching "Cooking with the Wolfman" on APTN (Aboriginal Peoples Television Network) while we get the kids ready for school. We prepare more meals that are tasty and healthier. |
- Not enough physical activity
Most Canadians are less active than their grandparents. "This hard work was what kept us healthy," says Elder Audrey Kornylo in her story about growing up on the trap line in Manitoba and a life without running water and electricity. Aboriginal Peoples now spend many hours in front of a television or computer screen and less time outdoors.
According to one survey of Aboriginal communities, walking is the most common exercise, but only 21% of First Nations adults do 30 minutes of physical activity a day. This may be due to bad weather and road conditions, unsafe neighbourhoods, and lack of access to fitness facilities.
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I now play floor hockey three nights a week. A lot of us are interested in baseball, so I will help organize a league this summer. But the biggest change I made was also the easiest; I walk to work instead of using my 4-wheeler. People ask me, "Is your machine broken?" |
- Yes, smoking is involved
Smoking increases the risk of colorectal cancer. Over 50% of First Nations adults smoke, compared to only 20% of non-Aboriginal people. An even bigger concern is the high rates of smoking among youth: 61% of young First Nations females smoke and 47% of young First Nations males. 70% of Inuit smoke and 57% of Métis smoke.
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My cousin Nadine went out to a six-day tobacco recovery program near Edmonton. I joined her for the follow-up session. If she could do it, I could do it. She told me what the program was going to be like and by the time I got there, I was ready to quit. In the last six months, I haven't smoked 2,000 cigarettes. Nadine and I help each other through hard times. We're happy that some of our friends want to quit now that we are smoke-free. |
Promoting healthier lifestyles to reduce colorectal cancer
Across Canada, Aboriginal communities are working together to stem the tide of rising rates of colorectal cancer and other chronic diseases:
- Stop smoking program respects Aboriginal traditions and values
A unique Tobacco Recovery pilot project launched last year in Alberta featured massage therapy, good food, exercise, fun, and ceremonies lead by a First Nations Tobacco Addiction Specialist. A doctor also supported these workshops.
New non-smokers returned to their reserves with confidence, knowing that they could support each other to remain smoke-free. People returned after six weeks for a five-day follow-up and became mentors for newcomers. The workshops were supported by Treaty 8 First Nations of Alberta with the help of the First Nation and Inuit Tobacco Control Strategy (FNITCS), the Alberta Regional Tobacco Advisory Committee (ARTAC) and Patient Support International.
- Walking the way to health
While tackling obesity and diabetes, the people of Sandy Lake First Nation, Ontario are also helping people reduce the risk of developing colorectal cancers. They produce local radio programming to highlight healthy lifestyle activities, work with a local grocery store on healthy food labeling, and go on home visits to promote healthy food preparation.
The jewel in the crown of this program is the new community network of walking clubs and walking trails. Paths run through the bush, crossing the dusty roads, cutting from one end of the community to the other. Built by community members, this six km trail system promotes walking as a healthy alternative to using motorized vehicles. They also hold Poker Walks where you pick up a card at intervals along the path and see who has the winning hand.
According to Rodrick Fiddler, Sandy Lake's Diabetes' Coordinator, "young people have a better attitude toward diet and exercise, and more awareness about what they can do to prevent these diseases."
- Dancing the way to health
Break dancing is popular with Inuit youth. The Nunavut government brought the hip-hop dance troupe The Canadian Floor Masters from Ottawa to three schools to promote self respect, teamwork, physical achievement and school attendance. Following the recent workshop in Clyde River, teens continue to show up for practice two nights a week where they receive a healthy snack.
- Online recipes to make healthy eating easier
Community web sites serve up some great cooking recipes. Check out healthy recipes like those from the Kahnawake Schools Diabetes Prevention Project (KSDPP) and the Federation of Newfoundland Indians. Health professionals can explore the Database of Nutrition Intervention Activities prepared by KSDPP for ideas for local nutrition projects.
The National Aboriginal Health Organization's Métis Centre cookbook and guide to healthy living includes information on losing weight and maintaining a healthy body weight, using traditional food and Métis recipes.
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What can Aboriginal Peoples do to protect themselves?
- Get tested for colorectal cancer! If you are over 50, have a fecal occult blood test (FOBT) at least every two years. Your doctor or health professional can help you find out about the best test for you.
- Maintain a healthy body weight. You can assess your current weight with the Dietitians of Canada's Eating and Activity Tracker.
- Eat healthier! Eat country or traditional food, including high fibre whole grains and vegetables such as cabbage, broccoli, carrots, peppers, and oranges. A diet high in vegetables and fruit is known to lower risk.
- Choose healthy fats instead of harmful fats and choose lower fat options more often.
- Limit alcohol.
- Exercise more! Go fishing or hunting, walk to work or at least part of the way, play actively with your children, and participate in community dances.
- Quit smoking! There are many approaches and programs available.
- Maintain a healthy lifestyle. There are many other things that you can do to reduce your risk of the main four diseases that affect adults: cancer, heart disease and stroke, lung disease, and diabetes.
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Although the rise in colorectal cancer rates in Aboriginal communities is alarming, programs already in place to combat diabetes and smoking are making people aware of the connection between lifestyle and health.
Change isn't easy, but as more and more people quit smoking, become active and eat a healthy diet, they are improving not only their own health, but are also influencing the health of generations to come.
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This article was prepared by the 
