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Cancer Incidence in the Peace River South Local Health Area Prepared by: Ryan Woods, Scientific Director, BC Cancer Registry 8C Cancer nwoods@becre.ca Data Description ‘The data provided in this section are sourced from the BC Cancer Registry which captures information on all cancers diagnosed in BC residents We have examined data for the most recent 10- ‘year period for which statistics have been generated from the BC Cancer Registry — 2005-2014, More recent data will be available in the coming months. Fopulation data used in the calculation of cancer rates js based on PEOPLE version 2016 from BC Stats. Dawson Creek is part of the Peace River South Local Health Area (which also includes Chetwynd and areas surrounding these communities). Thus the data presented here are for an area larger than the specific municipality of Dawson Creek. Cancer groupings are defined to align with BC Cancer statistical reports and national cancer statistics reports and specific definitions are available upon request. All Cancers Over the 10-year period from 2005 to 2014, 1193 cancers were diagnosed in the Peace River South LHA. Of these, 559 were diagnosed among females; 634 in males. To give some perspective on total numbers in the Northern Health region over this period, there were 12,407 total cases of cancer diagnosed, ‘As noted in Table 1 below the number of total cancers diagnosed in this region are consistent with Northern Health regional rates; the number expected based on regional rates is almost identical (1193 vs 1201). Table 1: Registered and Expected Cancers in Peace River South, 2005-2014 Registered Cancers ] Cancers Expected Based on _| Standardized Incidence Northern Health Average Rates Ratio 1193 01 0.99 Summaries of Specific Cancers ‘The most common cancers diagnosed in this region were lung, prostate, breast and colorectal, accounting for more than 58% of the cancers diagnosed over this period in Peace River South. These were the most common cancers diagnosed in BC as well during this period accounting for 53% of all cancers diagnosed in BC. In Table 2 below we present the observed counts from the 10-year period for common cancers inthis region. We have chosen to present the most common 10 cancers in the region, however these are also cancers that have more reasonable counts for compiling statistics (all have an average of 3 cases per year or more). The standardized incidence ratio (SIR) for the individual cancers suggests that there are some cancers where the observed number of cases is greater than would be expected based on average Northern Health rates, and others where the number of cases is less than expected. None of these SIRs is statistically significantly different than aratio of 1 (an SIR of 1 means the observed numbers of cases are equal to those that would be expected based on regional rates). We have provided some additional comments regarding some of the cancers that show SIRs >1. (elevated); please do note that these elevations were however not statistically significant. Prostate cancer incidence is strongly tied to the use of PSA testing in the population and it is not uncommon to see large fluctuations in this rate regionally. Stomach cancer incidence has been reported higher in northern communities in Canada; in BC, rates of stomach cancer are higher in the north than elsewhere inthe province. Known risk factors for this cancer indlude infection with H pylori bacteria, smoking and certain genetic conditions. Leukemia showed an elevated SIR however we observed about 4 cases of leukemia annually in this region and expected between 3 and 4 and thus the assessment is based on small numbers. Known risk factors for leukemia incluse exposure to radiation, prior cancer treatments such as chemotherapy and radiation therapy, smoking, benzene exposure and some family genetic syndromes, Table 2: Registered and Expected Cancers in Peace River South, 2005-2014 Cancer TotalNumber | Average | Standardized incidence 2005-2014 | number of Ratio cases per year | (Based on Northern Health Average Rates) Lung 188 19 0.98 Prostate 179 18 1.10 Breast 164 16 1.10 Colorectal 156 16 1.04 Non-Hodgkin lymphoma 52 5 0.95 Bladder 45 5 0.81 Leukemia 43 4 1.22 Uterine 37 4 1.09 Stomach 30 3 1.18 Kidney 25 3 0.91 BC CAN CER We did examine a number of other cancers 2s part of our examination however the number of cases is small and the cancer rates thus become highly variable. Some examples include SIR estimates for multiple myeloma, laryngeal, and pancreatic cancers showing observed counts more 35% lower than expected but being based on only about 1 incident case per year. Similarly, Hodgkin lymphoma and testicular cancers showed elevated SIR’s but were also based on an average of only 1 incident case per ‘year and thus cannot be interpreted as statistically meaningful. Impression Overall cancer incidence over the past 10 years in this region is consistent with average cancer rates in Northern BC. A few individual cancers have shown elevations over what would be expected based on Northern Health rates, however none of these were statistically significant. A number of cancers as expected also showed lower rates than what would be expected based on average Northern Health rates. The elevated leukemia SIR has been examined once in the recent past (fall, 2017) when we received an inquiry related to whether cancers linkec to benzene exposure might be elevated in the North-East of BC. As benzene is a risk factor for leukemia, we examined this at that time. Acute Myeloid Leukemia (AML) is a subtype of leukemia specifically inked to benzene exposure and we examined whether this type of leukemia was elevated in the North-East region. Our findings from that analysis suggested there was no observed excess of AML in the North-East (Observed count 2005-2014: 16 ‘cases; Expected count, 2005-2014: 17-18 cases). Of the 16 cases identified at that time, only 6 were from Peace River South and thus this is less than 1 case per year. The proportion of AML cases from the North-East diagnosed in this LHA are consistent with the proportion of the population of the North-East that resides in the Peace River South region. Further statistical analysis of this specific cancer at the local health area level would not yield meaningful results. We can continue to monitor leukemia incidence in the region and provide data to the medical health officers as more becomes available.