title: Cancer incidence, morbidity, and survival in Canadian first nation children: a Manitoba population-based study from the cancer in young people in Canada (CYP-C) registry.
abstract: BACKGROUND
  Health disparities between Canadian First Nation (FN) people and the rest of the national population exist. No studies have specifically documented cancer-related health outcomes in Canadian FN children. The purpose of this study was to describe the incidence of pediatric malignancies in Manitoba FN children, and to compare morbidity patterns and survival between FN and non-FN children with cancer in the Canadian province of Manitoba.
  
  
  METHODS
  A retrospective, population-based review of all children (0-14.99 years) diagnosed with malignancy (2001-2008) in Manitoba, Canada was undertaken using the Cancer in Young People in Canada registry. FN children were compared to the non-FN population for markers of morbidity and survival.
  
  
  RESULTS
  The average annual age-standardized incidence rate for all childhood cancers in FN children was 132 per 1,000,000 per year. 240 children were included in the morbidity and survival analyses (38 FN; 202 non-FN). No differences were found between FN and non-FN children in time from first presentation of symptoms to consultation with an oncology specialist or diagnosis, or number of hospital admissions / total days of admission for treatment complications. Overall survival was inferior for FN children in univariable analysis (P = 0.048) but not when risk group was included in a multivariable analysis (P = 0.15). No difference in event free survival or cumulative incidence of relapse was identified.
  
  
  CONCLUSIONS
  The estimated incidence of childhood cancers in the Manitoba FN population is similar to provincial incidence rates. No differences in morbidity patterns or survival were found between Manitoba FN and non-FN children with cancer.
authors.affiliation: Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.
authors.forename: David M
authors.initials: DM
authors.lastname: Stammers
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Israels
authors.forename: Pascal J
authors.initials: PJ
authors.lastname: Lambert
authors.forename: Geoff D E
authors.initials: GD
authors.lastname: Cuvelier
mesh_terms: D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009017:Morbidity; D009367:Neoplasm Staging; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D012017:Referral and Consultation; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Aboriginal; Canadian First Nations; Native American; North American Indian; childhood cancer; incidence; morbidity; survival