Health care inequities behind shorter life spans for Inuit from Nunavik with lung cancer

A new study shows that people living in the Inuit region of Nunavik in northern Quebec die earlier after a diagnosis of lung cancer than Montreal residents receiving treatment at the same cancer centre.

Source : CMAJ

All inhabitants of Nunavik are investigated and treated for cancer at the McGill University Health Centre (MUHC) in Montreal, more than 1400 km away from Nunavik hospitals, due to limited resources in the region. 

A recent study led by Dr. Faiz Ahmad Khan at the Research Institute of the McGill University Health Centre (RI-MUHC) compared lung cancer survival between 95 Nunavik and 185 Montreal residents being treated at the MUHC and found that Nunavik residents with similar stages of lung cancer had shorter survival than Montreal residents, even after accounting for other differences between the groups. 

Analyzing results with community representatives in Nunavik pointed to chronic health care under-resourcing as a possible root cause of these survival differences.

"We underscore that our results should not be interpreted to conclude that Inuit have a genetic predisposition to worse lung cancer outcomes. Rather, our study observations contextualized with other knowledge about health services and access in Nunavik point to chronic underfunding and under-resourcing of Nunavik's health care services, as well as the lack of Inuit representation in health care provision, as likely upstream determinants of the disparity observed in our study," writes Dr. Faiz Ahmad Khan, a respirologist at the MUHC, Scientist in the Translational Research in Respiratory Diseases Program at the RI-MUHC and Associate Professor of Medicine at McGill University, with coauthors.

The authors recommend several actions to improve lung cancer survival for Nunavik Inuit, including:

• deploying Inuit-specific smoking cessation and prevention services
• making lung cancer screening available immediately, in an accessible, acceptable and culturally safe format, to facilitate earlier detection of lung cancer
• improving lung health services by, for example, creating x-ray capacity in villages
• supporting a Nunavik Inuit-specific lung cancer care plan
• providing training and employment for Inuit health navigators to support patients and families in Montreal
• increasing funding and human resourcing to strengthen Nunavik health care services

"In the bigger picture, observations such as ours should support Nunavik Inuit efforts toward greater self-governance, as increased Inuit decision-making over health care policy and funding will help ensure health services are aligned with the population's needs," adds Dr. Khan.

About the study

The study Nunavimmi puvakkut kaggutimik aanniaqarniq: Qanuilirqitaa? Lung cancer in Nunavik: How are we doing? A retrospective matched cohort study  was co-authored by Yue Chen, Sarah MacIsaac, Matthew Young, Marlene Ahodakin, Luke Wan Jeagal, Maryse Boucher, Jason Agulnik, Nathalie Boulanger, Sophie Camilleri-Broët, Nicole Ezer, Anne V. Gonzalez, Scott Owen, Carmela Pepe, Jonathan Spicer, Hangjun Wang, Shirley White-Dupuis, Larry Watt, Minnie Grey, Andrea Benedetti and Faiz Ahmad Khan.

DOI: https://www.cmaj.ca/content/196/6/E177

This work was funded by the Rossy Cancer Network.

Media contact
Fabienne Landry
Communications coordinator, Research, MUHC
[email protected]