Ahmed S, Shahid R K, Episkenew J A
Department of Medicine, Saskatchewan Cancer Agency, University of Saskatchewan, Saskatoon, SK; ; Department of Oncology, Saskatchewan Cancer Agency, University of Saskatchewan, Saskatoon, SK; ; Department of Community Health and Epidemiology, Saskatchewan Cancer Agency, University of Saskatchewan, Saskatoon, SK;
Department of Medicine, Saskatchewan Cancer Agency, University of Saskatchewan, Saskatoon, SK; ; Department of Community Health and Epidemiology, Saskatchewan Cancer Agency, University of Saskatchewan, Saskatoon, SK;
Curr Oncol. 2015 Dec;22(6):417-26. doi: 10.3747/co.22.2599.
Historically, cancer has occurred at a lower rate in aboriginal populations; however, it is now dramatically increasing. Unless preventive measures are taken, cancer rates among aboriginal peoples are expected to soon surpass those in non-aboriginal populations. Because a large proportion of malignant disorders are preventable, primary prevention through socioeconomic interventions, environmental changes, and lifestyle modification might provide the best option for reducing the increasing burden of cancers. Such efforts can be further amplified by making use of effective cancer screening programs for early detection of cancers at their most treatable stage. However, compared with non-aboriginal Canadians, many aboriginal Canadians lack equal access to cancer screening and prevention programs. In this paper, we discuss disparities in cancer prevention and screening in aboriginal populations in Canada. We begin with the relevant definitions and a theoretical perspective of disparity in health care in aboriginal populations. A framework of health determinants is proposed to explain the pathways associated with an increased risk of cancer that are potentially avoidable. Major challenges and knowledge gaps in relation to cancer care for aboriginal populations are addressed, and we make recommendations to eliminate disparities in cancer control and prevention.
从历史上看，原住民群体的癌症发病率较低；然而，目前这一发病率正在急剧上升。除非采取预防措施，否则预计原住民的癌症发病率很快将超过非原住民群体。由于很大一部分恶性疾病是可以预防的，通过社会经济干预、环境改善和生活方式改变进行一级预防，可能是减轻日益增加的癌症负担的最佳选择。利用有效的癌症筛查项目在癌症最易治疗阶段进行早期检测，可以进一步加大这些努力的力度。然而，与非原住民加拿大人相比，许多原住民加拿大人无法平等地获得癌症筛查和预防项目。在本文中，我们讨论了加拿大原住民群体在癌症预防和筛查方面的差异。我们首先介绍相关定义以及原住民群体医疗保健差异的理论视角。提出了一个健康决定因素框架，以解释与癌症风险增加相关的、可能避免的途径。探讨了与原住民群体癌症护理相关的主要挑战和知识空白，并提出了消除癌症控制和预防方面差异的建议。
