Nunavut must start earlier detection of cancer

Nothing illustrates the Nunavut government’s negligent approach to the early detection of cancer better than this message: “No services were found in your area.”

That’s from the website of the Canadian Cancer Society. You’ll see it if you search an area of their site set up for people who want information about the screening and early detection of breast, cervical and colon cancers.

So much for using Google to find help and information. Well-meaning health workers advised Janice Simailak of Baker Lake to do just that, at a time when she was already suffering the painful symptoms of intestinal cancer.

After being told to “Google her symptoms,” she made a smart move. She travelled to Toronto on her own to get her condition diagnosed.

Simailak’s situation is not uncommon. It exemplifies a serious gap in Nunavut’s health care system that causes too much unnecessary human suffering and too many untimely deaths.

That gap lies in the absence of something that exists in nearly all other Canadian provinces and territories: a strategy for the early screening and detection of cancer.

Numerous residents, including MLAs, have complained about this. In March 2013, Keith Peterson, then the Nunavut health minister, described Nunavut’s cancer detection practices like this: “we rely on patients themselves to get to health centres.”

But when patients do that, they don’t get early referrals to qualified doctors or oncologists. They don’t get early screening.

They do get a couple of free Tylenols, usually, along with advice about searching the internet for more information about their symptoms.

The result? Too many people are diagnosed only after their symptoms have progressed to an advanced stage, when treatment is more difficult, more expensive and much harder on the patient. Too many people die before their time and too many others endure costly therapies that could have been avoided had their cancers been detected earlier.

This is not a subjective perception, fueled by grief and anger. This is an objective fact, supported by hard evidence.

The Canadian Cancer Society, in a report released in May 2013, found that when cancer strikes Nunavut residents, it kills at a higher rate than anywhere else in the country.

The report found the incidence rate for cancer in Nunavut between 2005 and 2009 was actually lower than for most other Canadian jurisdictions: 382 per 100,000.

That’s less than the Canada-wide rate of 467 per 100,000.

But when Nunavummiut do get cancer, they are more likely to die than Canadians living just about everywhere else.

Nunavut’s death rate for cancer for the same period — 2005 to 2009 — stood at 391 per 100,000. That’s well above the Canada-wide rate of 192 per 100,000.

The gap is most acute in the comparative death rates for women: 330 per 100,000 for Nunavut and only 137 per 100,000 across Canada.

For colorectal cancer, which is treatable in 90 per cent of cases — if detected early — Nunavut’s death rate is about four times higher than for Canada.

The early detection of cancer saves lives and it saves money. Yes, we all know it’s not easy to provide health care to a small population scattered across two million square kilometres of land.

But on this issue, the evidence is in and what the evidence says about health care in Nunavut is appalling. The Government of Nunavut must start work now on a screening and early detection system for cancer. JB