title: Cancer incidence, mortality, and stage at diagnosis in First Nations living in Manitoba.
abstract: BACKGROUND
  In the present study, we examined breast (bca) and colorectal cancer (crc) incidence and mortality and stage at diagnosis for First Nations (fn) individuals and all other Manitobans (aoms).
  
  
  METHODS
  Several population-based databases were linked to determine ethnicity and to calculate age-standardized incidence and mortality rates. Logistic regression was used to compare bca and crc stage at diagnosis.
  
  
  RESULTS
  From 1984-1988 to 2004-2008, the incidence of bca increased for fn and aom women. Breast cancer mortality increased for fn women and decreased for aom women. First Nations women were significantly more likely than aom women to be diagnosed at stages iii-iv than at stage i [odds ratio (or) for women ≤50 years of age: 3.11; 95% confidence limits (cl): 1.20, 8.06; or for women 50-69 years of age: 1.72; 95% cl: 1.03, 2.88). The incidence and mortality of crc increased for fn individuals, but decreased for aoms. First Nations status was not significantly associated with crc stage at diagnosis (or for stages i-ii compared with stages iii-iv: 0.98; 95% cl: 0.68, 1.41; or for stages i-iii compared with stage iv: 0.91; 95% cl: 0.59, 1.40).
  
  
  CONCLUSIONS
  Our results underscore the need for improved cancer screening participation and targeted initiatives that emphasis collaboration with fn communities to reduce barriers to screening and to promote healthy lifestyles.
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, MB; Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB.
authors.forename: K M
authors.initials: KM
authors.lastname: Decker
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, MB; Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB; Cancer Control Research, BC Cancer Agency, Vancouver, BC.
authors.forename: E V
authors.initials: EV
authors.lastname: Kliewer
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, MB; Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB.
authors.forename: A A
authors.initials: AA
authors.lastname: Demers
authors.affiliation: Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB.
authors.forename: K
authors.initials: K
authors.lastname: Fradette
authors.affiliation: Screening Programs, CancerCare Manitoba, Winnipeg, MB.
authors.forename: N
authors.initials: N
authors.lastname: Biswanger
authors.affiliation: Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB.
authors.forename: G
authors.initials: G
authors.lastname: Musto
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, MB.
authors.forename: B
authors.initials: B
authors.lastname: Elias
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, MB; Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB.
authors.forename: D
authors.initials: D
authors.lastname: Turner
keywords: Colorectal cancer; breast cancer; indigenous health