Since the earliest days of the development of the Maamwesying Ontario Health Team in early 2022, we have been measuring our progress in increasing screening tests which have been shown to prevent common conditions from worsening.

Cancer mortality (death) is significantly higher in First Nations People than in non-Indigenous people in Ontario, particularly for lung, colorectal, kidney, cervical and liver cancers. (1)

Less than half of First Nations males (43%) and females (49%) survived 5 years or longer after a cancer diagnosis compared to over half of non-Indigenous males (54%) and females (60%) in Ontario. (2)

In the Northeast, rates of non-traumatic lower limb amputations are twice as high as the Ontario average, and Indigenous Peoples have rates of diabetes that are 3-5 times higher than non-Indigenous Peoples. (3)

Risk Factors for Indigenous Peoples (4) include:

• Smoking commercial tobacco – First Nations adults are 2x more likely to smoke cigarettes than other adults
• Drinking alcohol – even small amounts of alcohol can increase the risk of many cancers
• An unhealthy diet – First Nations adults are more likely to live in households that are food insecure (with low availability of culturally appropriate food, or worries about running out of food)
• Weight and physical activity – about 3 in 4 First Nations adults are overweight or obese with on reserve First Nations adults less likely to be physically active compared to off-reserve First Nations adults or other adults. Women are less likely to be physically active than men.

• Cervical Cancer Screening with pap tests for people with a cervix age 21 – 70 who are eligible (every 3 years for most)
• Breast Cancer Screening with mammograms for those aged 50-74 who are eligible (every 2 years for most). Please take note of the available early screening option (ages 40-49), even if you do not have a family history or other risk factors. (5)
• Colorectal Cancer Screening for those aged 50-74 who are eligible (every 2 years for most and can be done w/ home test)
• Reduce non-traumatic foot amputations through the Inlow’s 60 second foot screen and Wound Assessments
• Measure Alternate Level of Care Days**
• Improve access to mental health and addictions supports to reduce emergency department visits for crisis care

• Implemented a Preventative Care Toolbar in electronic medical records (EMR), making it easier for a person’s healthcare team to determine if screening is needed, and improving the capture of data for consistent quality improvement
• Year over year increases in eligible people who are up to date with Pap tests
• Year over year increases in eligible people who are up to date with Mammograms
• Year over year increases in eligible people who are up to date with at home Fecal Immunochemical Testing (FIT )
• Implemented a toolbar for Primary Care Providers to facilitate 60-second diabetic foot screens
• Increases in lower limb assessments
• Implementation of offloading / plantar pressure redistribution to speed healing for patients with wounds

*Diabetes Mellitus and Peripheral Vascular Disease

** Alternate Level of Care Days are the number of days a hospital bed is occupied by a patient who longer needs acute care services, but are waiting for availability in a more appropriate care setting.

1 First Nations, Inuit, Métis and Urban Indigenous Cancer Strategy 2019-2023

2 Cancer in First Nations People in Ontario: Incidence, Mortality, Survival and Prevalence

3 Ontario Framework for Lower-Limb Preservation October 2021

4 First Nations People: Cancer Risk Factors and Screening

5 Although Ontario First Nations women are slightly less likely to be diagnosed, breast cancers in First Nations women are more likely to be diagnosed at a a later stage, compared with non-Indigenous Ontario women. Cancer in First Nations People in Ontario: Incidence, Mortality, Survival and Prevalence