The Yukon’s biggest killer

After a series of columns on fiscal policy, I thought readers this week might enjoy a new topic: cancer.

After a series of columns on fiscal policy, I thought readers this week might enjoy a new topic: cancer.

It turns out that the leading cause of death in the Yukon is not, as some Outside folks seem to think, getting eaten by grizzlies after eating Kentucky Fried Chicken in your tent. Or freezing to death after falling through the ice. Or getting trapped on Mount Logan by earthquakes.

Our biggest killer is cancer.

Statistics mavens in the Office of the Yukon Chief Medical Officer of Health just put out a fact-filled report on the grim disease’s grip on the territory.

First, the good news. Cancer death rates have been declining for men since 1999 and for women since 2005. In terms of cancer-cutting behaviours, Yukoners beat the national average in terms of physical activity and eating lots of fruit and vegetables.

I think Yukoners should get extra points for the fruit and vegetables given what one finds sometimes in the local produce aisles.

Now the bad news. One death in three in the Yukon is related to cancer, or about 60 Yukoners per year. Female victims lose 14 years of life to cancer, on average, and men nine years, compared to how long they would have been expected to live without the disease.

The report uses a statistic called the Age Standardized Mortality Rate (ASMR). Think of this as how many people die of cancer in a population, corrected for differences in the mix of old and young people between jurisdictions and over time.

Although cancer rates in the Yukon have been declining in recent years, our ASMR from 2008 to 2012 was 21 per cent higher than Canadian averages. The report’s statisticians point out that this finding is “statistically significant,” meaning that this higher death rate is highly unlikely to be a fluke of the numbers.

The ASMR for men in 2014, for example, was about 0.18 per cent in Canada versus about 0.23 per cent in the Yukon. It doesn’t sound like much as a statistic, but given our population it means a couple of dozen extra dead Yukoners. It’s not a minor statistic to them, or their loved ones.

The ASMR for Yukon women is lower than that for men, but still significantly higher than the average for Canadian women.

Lung cancer is the biggest killer among cancers, taking 30 per cent of the toll. Lung cancer is not only a problem for smokers. Radon, that invisible and odorless gas that seeps into our basements, is responsible for around one lung cancer victim in six across Canada.

The statistics clearly identify smoking as a problem. The Yukon has higher smoking rates than any province, although our numbers are declining. Lung cancer rates among men are falling but, troublingly, rates among women continue to rise. In fact, lung cancer rates for Yukon women are a whopping 45 per cent higher than for Canadian women overall.

Another troubling fact is that more younger Yukoners die of cancer than in the national population. In the Yukon, 46 per cent of cancer deaths were in people aged less than 70. The national figure is 38 per cent.

Also, cancer rates appear to be higher outside Whitehorse than in the capital. Although the difference stands out visually on the charts, the difference is not big enough to be considered statistically significant by experts given our small sample sizes. Nonetheless, the report mentions troubling national studies that found that death rates among rural Canadians for lung and colorectal cancer were higher than for city folk, and that rural Canadians in some parts of the country have less access to early detection, screening and treatment.

The National Post recently published an online infographic that showed the cancer rates by regions across the country. Nearly every chart showed a disturbing pattern of rural and Northern regions with higher rates than the big cities.

So what does all this mean for Yukoners?

First, we can expect more cancer as our population grows and ages. The statistics don’t prove it, but there are some patterns that suggest rural and Northern Canadians have less access to effective screening and treatment for cancer. I am a cancer survivor myself, and consider that I got excellent care from my doctors and the Whitehorse hospital. Nonetheless, our politicians and health officials could do worse things with our transfer payment funds than invest in further building up the Yukon’s cancer care capabilities over the next ten years.

As for you personally, you should talk to your doctor and be cautious about taking advice from the internet or local economics columnists. With that warning in place, and since this is important to all of us, bear with me as I try to summarize the top recommendations from the Medical Officer of Health’s report. Think of it as the Yukonomist Nine Point Plan to Dodge Cancer.

Quit smoking. Lung cancer is the leading cause of cancer death here.

Drink less. Studies suggest 3.5 per cent of cancer deaths are attributable to booze.

Eat well, including foods high in fibre, fruits and vegetables. Even though Yukoners already do better than the national average in this area, you can probably do more. You should also avoid foods high in fat, red and processed meats, and salty fare.

Lose weight. Some 57 per cent of Yukoners surveyed in 2014 described themselves as overweight or obese.

Get more physical activity. For adults, experts recommend 150 minutes per week of moderate to vigorous physical activity. Watching other people play sports on television does not count, although brisk walking does.

Sit less. A local teenager recently told me that “sitting is the new smoking.” Even when not doing your 150 minutes of brisk walking mentioned above, you should try more standing and moving around. Get a standing desk, or stand at meetings or when talking on the phone, for example.

Avoid too much sun and wear your sunscreen.

Get your house tested for that silent killer, radon.

Avoid scary sounding infectious agents like Helicobacter Pylori and Human Papilloma Virus. I don’t know how to do that, but your doctor probably does.

You’ll also be disturbed to hear that some of these cancer-linked activities may reinforce each other. For example, next time someone offers you a smoke and a beer at the same time, quote the report to them: “Alcohol consumption interacts synergistically with tobacco smoking to increase the risk for certain cancers.”

Think about how many parts of the Nine Point Plan to Dodge Cancer you are flouting when you have a cigarette and a rye and coke while you enjoy salty snacks and sit around binge-watching Game of Thrones in your basement TV room, which in the Yukon you might as well call The Radon Pit. You’re practically asking the tumours to start popping like popcorn.

Some causes of cancer, such as our genetics, we just have to live with. But some causes we can control. And knowing what they are can help.

Keith Halliday is a Yukon economist and author of the MacBride Museum’s Aurore of the Yukon series of historical children’s adventure novels. He is a Ma Murray award-winner for best columnist.