Study highlights health care disparities for Nunavik Inuit with lung cancer

According to new research published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.230682.

All Nunavik residents are screened and treated for cancer at the McGill University Health Center (MUHC) in Montreal, more than 1400 kilometers away from Nunavik hospitals, due to limited resources in the region.

The researchers compared lung cancer survival among 95 Nunavik residents and 185 Montreal residents treated at the MUHC. They found that Nunavik residents with similar stages of lung cancer had shorter survival than Montrealers, even after accounting for other differences between the groups.

Analysis of the results with community representatives pointed to a chronic lack of health care resources as a possible root cause of these survival differences.

“We emphasize that our results should not be interpreted to conclude that Inuit are genetically predisposed to worse lung cancer outcomes. Instead, our study’s observations combined with other knowledge about health services and access in Nunavik point to the chronic underfunding and under-resourcing of Nunavik’s health care services, as well as the lack of Inuit representation in health care delivery, as likely antecedent determinants of the inequality observed in our study” writes Dr. Faiz Ahmad Khan, pulmonologist and associate professor, MUHC, Montreal, Quebec, with co-authors.

The authors suggest several actions to improve lung cancer survival for Nunavik Inuit, including:

• Developing Inuit-specific smoking cessation and prevention services
• Immediate availability of lung cancer screening in an accessible, acceptable and culturally safe format to facilitate early detection of lung cancer
• Improving lung health services, for example by building X-ray capacity in villages
• Supporting a Nunavik Inuit-specific lung cancer care plan
• Providing training and employment for Inuit health navigators to support patients and families in Montreal
• Increase funding and human resources to strengthen Nunavik health care services

“In the bigger picture, observations like ours should support Nunavik Inuit efforts for greater self-governance, as increased Inuit decision-making about health care policy and funding will help ensure that health services are aligned with needs of the population.“