Health experts say several factors explain N.B.'s high cancer rate

New Brunswick's cancer screening levels could be an explanation for the province's higher cancer rates, health experts say.

In a Statistics Canada report this week, New Brunswick is reported to have the second-highest cancer rate per 100,000 people in Canada.

The figures are from 2019 and indicate the province's incidence rate of new cancer cases for that year is 655 per 100,000 people.

The figure sits higher for males, with a rate of 722.9, the highest in Canada. For females, the cancer incidence rate is 589.7, down from 619.1 in 2018, but still the second-highest in the country in 2019. 

The most common type of cancer in New Brunswick in 2019, according to the data, was lung and bronchus cancer, at 99.1 cases per 100,000 people, followed by prostate cancer, at 80.4 cases.

N.B. does more screening

"New Brunswick tends to have screening at a level that's among the best in the country," said Stéphane Robichaud, CEO of the New Brunswick Health Council. "So we do more screening for certain types of cancers."

In the 2020 health service quality report card from the council, the province received an A+ for colorectal cancer screening in 2017 for adults 50 to 74 years old, and for women 50 to 69 years old who received a mammogram within the last two years. 

"If you're doing more screening, then you're likely to be able to capture more than other jurisdictions as well," said Robichaud. 

Comparing the provinces and territories

Among the provinces, Newfoundland and Labrador had the highest rate of cancer incidence per 100,000 people with 692.6 cases. Alberta had the lowest, at 461.4. 

Among the territories, Yukon had the highest rate, at 423.1 cases per 100,000. Nunavut had the lowest, at 181.4. 

According to Dr. Iris Gorfinkel, a family doctor in Toronto and founder of PrimeHealth Research, there are a number of factors to consider when looking at cancer detection rates.

Factors influencing the higher rate

Potential reasons for why a province might have a high or low rate include provincial attitudes toward cancer screening programs, a lack of government programs, or primary care doctors not being able to offer proper preventive cancer care because of a lack of time or resources.

"When there are limited numbers of doctors, those doctors are going to attend to the acute problems, and attend to cancer prevention screening potentially much less," said Gorfinkel.

"Part of the answer may be trying to break down the barriers that people face from getting tested." 

Adam Bowie, speaking for the Department of Health, offered another  explanation for New Brunswick's high cancer rate.

"The number of new cases is mostly due to the province's population growth, and the fact that New Brunswick has one of Canada's oldest populations," Bowie said in an email statement.

Cancer incidence rates in Canada are generally higher in the East and lower in the West, Dr. Jennifer Gillis of the Canadian Cancer Society said in an email statement.

"The reasons aren't entirely clear but are likely at least partly due to differences in demographics, such as age of the population, as well as rates of modifiable cancer risk factors, such as tobacco use, alcohol consumption, physical inactivity and obesity," said Gillis. 

"Caution is needed when comparing between provinces and territories, as true differences can be hard to detect in regions with smaller populations because they are more vulnerable to large year-to-year swings than larger regions."

Decreased mortality rates 

Despite the increase in incidence rates in 2019, mortality rates declined for all cancers combined in both male and female patients, according to a Department of Health report.

The report noted that lower mortality rates were observed in lung and bronchus, prostate, and stomach cancers in male patients.

In female patients, there were lower mortality rates in stomach, colon excluding rectum, pancreas, lung and bronchus, breast, cervix uteri, and ovarian cancer.