Lung cancer screening in Canada 2021/2022

Strategies to improve screening for First Nations, Inuit and Métis

First Nations, Inuit, and Métis populations have higher smoking rates and other risk factors than non-Indigenous people in Canada, putting them at a higher risk for developing lung cancer. Therefore, it is important for lung cancer screening programs to engage with these populations.

Screening programs in three provinces and report work with First Nations, Inuit and/or Métis to increase participation and improve the screening experience. This work includes engaging First Nations, Inuit and Métis in decision-making and informing approaches to culturally appropriate screening and program resources, such as social media campaigns, and engaging with and educating healthcare providers working directly with First Nations, Inuit, and Métis communities.

As jurisdictions plan for implementation of lung cancer screening programs, most are also planning to work with First Nations, Inuit, and/or Métis communities.

Strategies to improve screening for First Nations, Inuit and Métis*

P/T  Intended audiences Strategies used  Strategy co-developed with community?   Description 
BC · First Nations
· Inuit
· Métis
· Development of culturally safe materials and resources
· Promotion of health literacy
· Direct community engagement to co-design programs
All: ✓ Representation of various communities on patient pathway working group
ON · First Nations
· Inuit
· Métis
1. Group education and mass media
2. Promotion of health literacy
3. Development of culturally safe materials and resources
4. Providing transportation to screening services (First Nations through NIHB)
5. Direct community engagement
1. ✓
2. ✓
3. ✓
4. ✓
5. ✓
· Through the Indigenous Cancer Care Unit (ICCU), Regional Indigenous Cancer Leads and regional teams, communities are engaged to inform programs/initiatives to improve education and awareness of lung cancer screening.
· There are also more targeted educational sessions through the Indigenous Tobacco Program (ITP) and smoking cessation counselling.
· Participant Information Sheets and recruitment brochures were designed and tailored for each First Nation, Inuit and Métis population. These materials were informed by Indigenous partners and translated into the Ojibway, Inuktitut, French, and Mohawk languages.
· The ICCU also worked with members of the regional screening teams at pilot site hospitals to provide Ownership, Control, Access and Possession (OCAP®) training and embed these data governance principles within program policies and processes. It’s expected that members of the program that work with the voluntary Indigenous self-identification data have been trained and follow Indigenous data governance principles (i.e. OCAP®, Métis collective and self-determined data management and governance principles and Inuit data governance principles).
· The ICCU continues to raise awareness with regional and community partners about medical transportation coverage available to eligible First Nations through the First Nation Inuit Health Branch (NIHB) Insured Health Benefits for lung cancer screening.
· Commencing in August 2021, the ICCU will be co-leading a research project with the Akausivik Inuit Family Health Team to understand the current barriers within existing pathways to lung cancer screening, sharing test results back to participants, and facilitating access to treatment and follow-up care among Inuit (particularly in the Ottawa/Champlain region).
· A grant received by Dr. Jill Tinmouth and Dr. Amanda Shephard (“Catching Cancer Early how well do Ontario screening programs perform for First Nations and Métis persons?”) will provide Ontario Health (Cancer Care Ontario) with strategies to improve participation for First Nations and Métis people and may inform cancer screening recommendations in these populations.
· Through the relationships developed and fostered by the ICCU, regional teams have been able to continue working with communities as guided through the First Nations, Inuit, Métis and urban Indigenous Cancer Strategy.
QC · First Nations
· Inuit
· Métis
· Meeting with the Ministry of Indigenous Affairs of Quebec
· Involvement of the heads of Indigenous communities in institutions
· Translation of posters into the Inuit language
· Letter sent to family doctors in charge of Indigenous communities
· Radio messages
NS · First Nations · Strategies not yet developed. · Sipekne’katik community has expressed strong interest in development and early adoption of program. We are in the very early stages of working with them to identify and design a program that meets the needs of their community.

*New Brunswick plans to leverage the recommendations from the ongoing project “Developing Strategies for Underscreened Populations through Community Engagement.”

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