New Brunswick leads country in breast, lung cancer rates

New Brunswick has the highest rates of newly diagnosed breast cancer andlung cancer cases in the country, and the second-highest rate of new cancer cases overall, according to new figures from Statistics Canada.

Theprovince's breast cancer rate was80.9 per 100,000 in 2017, with 620 new cases diagnosed, thedata released Wednesday show.

By comparison, thenational rate, excluding Quebec, was68.4.

And while the national rate decreased from the previous year, New Brunswick's breast cancer rate grewsteadily three years in a row, up from 71.1 in 2013.

"It's upsetting,"said breast cancer survivor Kathy Kaufield of Quispamsis. "It's not a statistic that New Brunswick should be proud of."

The province also led the country for the incidence rateof new lung and bronchus cancers in 2017, at 103 per 100,000. A total of 790 cases were diagnosed, the figures show.

Nova Scotia was a close second at 102.1 per 100,000,with 970 new cases.

Across Canada, the incidence rate was 64.5.

New Brunswick's total rate for the 58 types ofcancers tracked was631.9 per 100,000,(4,845 cases), with Nova Scotia virtually tied at 631.8, (6,006 cases).

Only Newfoundland and Labrador ranked worseat 670, (3,540 cases).

The national rate was 529.1.

Aging population affects numbers

But New Brunswick's growing cancer numbers appearworse than they are because the majority of cancer cases are diagnosed in people over the age of 50, and the proportion of theprovince's population in that age group has been growing rapidly in recent years, forcing the numbers up.

According to a separate report from Statistics Canada, adjusting for age differences in New Brunswick's population between 2011 and 2017, cancer rates in each age group in the province have been falling, but the total number of cases are rising as more and more people enter the prime years for contracting the disease.

For example, breast cancer is five times more prevalent in women in their 60s than women in their 30s and New Brunswick has more 60-year-olds and fewer 30-year-olds than it did 10 years ago.The sheer number of women entering that age group is pushing overall totals up.

When the age of the population is factored in, New Brunswick drops from second place in the country for overall cancer ratesto seventh, witha rate muchcloser to the national average500.5 per 100,000, compared to495.9.

And the province's "age-standardized" incidence ratedropped duringthe five years of the report, "suggesting that many of the things we're doing are having an impact," said Dr. Eshwar Kumar, medical director of theNew Brunswick Cancer Network.

Even with the age adjustments, however, New Brunswick still ranks high for breast and lung cancers, in second and third place respectively.

Renews call for breast density info

Kaufield says figuring out why so many women in New Brunswick are getting breast cancer should be a research priority.

In the meantime, she's waiting for theprovincial government to follow through on a 2018 election pledge to provide women with their breast density information after mammograms so those with dense breastscanseek additional, more effective screening.

A Department of Health official has previously said the goal is to implement a new process for informing women about their breast density in 2020.

"The sooner the better as far as I'm concerned, especially when you see numbers like this," said Kaufield.

"The least we could do if we can't find out why it's so high in New Brunswick is give women every opportunity to find it as early as they can."

The cancer network is still "actively working" with the two regional health authorities to develop aprovincewide methodology for reporting mammographic breast density after routine screening, said Kumar.

He was unable to provide a specific timeline, saying thereare "a whole lot of IT issues" that need to be resolved.

Kumar said about 30 per cent of the province's breast cancer cases can be attributed to the screening program.

"We're detecting it at a much earlier stage than we did in the past, and patients are doing well with the interventions," he said.

"The encouraging thing from our point of view is that we know that the survival from breast cancer, particularly, isgood."

Kumar contends it's among the best in the country.

Lung cancer continues to be a "major problem," said Kumar.

Lung screening pilot in Ontario

Dr. Mahmoud Abdelsalam, the chief of oncology at the Moncton Hospital, who specializes in lung cancer,said about 90 per cent of cases can be attributed to smoking.

He'd liketo see the province add a lung cancer screening program.Early diagnosis improves survival rates, he said.

Kumar is part of a pan-Canadian groupworking on developing guidelines for a lung screening program. The group is awaiting the results of a pilot in Ontario, wherehigh-risk individuals are being offered low-dose CT scans to determine if they have lung cancer.

"There'sa lot of work that still needs to be done," said Kumar. But he expects the national guidelines will be ready to take to provincial governments for funding consideration over the course of the next year.

It's too soon to estimate how much such a program would cost in New Brunswick, he said.

If the funding were approved, it would take a least a year to set it up.

"What's important, I think, is to make sure that we have the processes and capacity in place to follow up on what we detect and to manage those appropriately."

Abdelsalamsays more study should be done to understand the risk factors contributing to New Brunwswick'scancer numbers.

"We need to look at what are the higher risks in our province could be the age, could be smoking incidence, could be the style of life, could be environmental factors, could be something else like genetics that we didn't check," he said. "So that needs more epidemiological studies."

Leah Smith,senior manager of surveillance for the Canadian Cancer Society, said about one in twoCanadians is expected to get diagnosed with cancer in their lifetime.

"So it's important when new stats like this come out that we pay attention and learn more about where we're making progress and where we need to do more."

Smith also pointed that about fourin 10 cancer cases are preventable and there are steps people can take to reduce their risk.

"Not smoking, maintaining a healthy body weight, moving more, sitting less, eating lots of fruits, vegetables,fibre and eating a diet low in bread and processed meat these things can all go a long way."