Cancer Screening Services in Southwestern Ontario, Canada
Background: First Nations and Métis (FNM) peoples experience a disproportionate burden of cancer as compared with non-indigenous populations in Canada. Their perceptions of cancer and their unique worldviews of health have a significant impact on the choices they make regarding participation in cancer screening.
Purpose: The purpose of this study was to gain an understanding of the perceived and experienced barriers that prevent or delay participation by FNM populations in breast, cervical and colorectal cancer screening, as well as those factors that are likely to promote their use of cancer screening services.
Setting and Sample: The study was conducted with 12 FNM communities located in both urban and rural areas of Southwestern Ontario. The sample included 107 participants.
Method: A qualitative interpretive study design was used within a participatory action research framework. Data were collected through personal interviews and focus groups. Thematic data analysis was completed to define the underlying common themes of experience in relation to cancer and cancer screening.
Results: FNM perceptions and experiences of cancer and cancer screening services are complex, deeply seeded, longstanding and vary by community. The collective experience of increasing rates of cancer within their close-knit communities has resulted in much fear about cancer.
The most commonly expressed barriers to participation in cancer screening among FNM groups were fear of being diagnosed with cancer, lack of knowledge about cancer and cancer screening, transportation issues, and mistrust of mainstream health care providers. Cancer screening procedures for breast, cervical and colorectal cancer were often perceived as painful, invasive, and offensive to FNM ways of being; especially in relation to their beliefs and values about privacy and modesty.
Conclusions: Cancer is a major concern among FNM peoples and they positively value ongoing community involvement in cancer education and screening activities. Participation in cancer screening among FNM peoples presents significant challenges due to a wide range of historical, socio-cultural, geographical, infrastructural and economic barriers.
Educational programs about cancer and screening processes need to be more culturally congruent with FNM worldviews of health and health care. Direct and ongoing consultation with FNM groups is essential to increase cancer awareness and screening rates within their communities.