Cancer Care Ontario Statistics

Subsections:

Parry Sound Districts Crude Cancer Rates vs. Age-Sex Adjusted Cancer Rates,
Cancer Care Ontario 2002
Local Health Integration Networks (LHINs)
Statistically-Significant Statistics
Lay Knowledge + Citizen Science

It’s been said that in 2002, Parry Sound District had the second¹ and third²highest cancer rates in Ontario. However, there are a few things to consider before reporting these stats: the difference between crude rates and age-sex adjusted rates as well as the size of the geographic region in which the data was collected.

Parry Sound District’s crude cancer incidence rate in 2002³:

• 652.8 of 100,000.
• 276 cases per 42,280 people (male and female)
• This was the third highest rate of 50 counties and districts

Crude rates are the number of cases divided by the size of the population (i.e. 100 out of 1000 equals 10%). Crude rates should not be used to draw conclusions until they have been adjusted for factors that might contribute to a statistic, such as: lifestyle, income, ethnicity, age and sex.

Therefore, a more relevant cancer statistic of Parry Sound would be an age-sex adjusted cancer rate. This statistic would account for the high senior populations and adjust accordingly.

Parry Sound District’s age-sex adjusted cancer rate in 2002⁴:

• 432.1 of 100,000
• 276 cases per 42,280 people (male and female)
• This was the ninth highest rate of 50 counties and districts

Download the excel spreadsheet of Cancer Care Ontario’s age-sex adjusted cancer rates for all 50 counties and districts from 1979-2002.

Prior to 2007, cancer statistics were measured by Cancer Care Ontario for 50 individual counties or districts. In 2007, that changed.

The province of Ontario increased the geographic area parameters by amalgamating counties and districts into 14 regions. These geographical regions are now called Local Health Integration Networks (LHINs)⁵, which is the level at which statistics are currently reported.

Parry Sound District is now part of the North East (NE) LHIN. The NE LHIN includes a total of about 7.5 districts⁶:

• James and Hudson Bay Coasts (about half of the District of Kenora)
• District of Cochrane
• District of Algoma
• District of Nipissing
• District of Temiskaming
• District of Sudbury
• District of Manitoulin
• District of Parry Sound

Therefore, statistics found on StatsCan at a LHIN level may miss highly local affects. An abnormally high rate of, for example, cancer in a small region would be more diluted than in statistics available prior to 2007 which were at a county level. In fact, the statistics divided into country and district prior to LHINs are no longer publicly accessible online or otherwise.

Map of Ontario’s Counties and Districts pre-LHINs⁷

Map of Ontario’s NE LHIN⁸

One of the rationales for reporting statistics at the LHIN level was to increase the sample size in order to provide statistically-significant data, because when data is reported for a small community, the number of events (e.g. cancer cases) is small and changes that seem dramatic can be due to chance alone.

Suppose a community had one cancer case last year and two this year - an increase of only one case caused the rate to double or increase by 100%. Suppose the second case was being investigated at the end of the year and, due to scheduling problems didn’t actually get diagnosed until the following January - a random scheduling problem would have (apparently) cut the rate of cancer in half. In contrast, had that single case been shifted to a different year in a larger geographic area where there were 1,000 cases, the impact of chance would be negligible. So, reporting data for larger areas reduces the impact of chance. However, that decision means that granular data at the community level is now lost.

Dr. Janet Hux is a former senior scientist at the Institute for Clinical Evaluative Sciences (ICES), current Chief Scientific Officer at Diabetes Canada and a Gumption Inc. board member, explains statistically-significant statistics further in the video below.

What does all of this mean for Parry Sound?

In the case of the town of Parry Sound, Nobel or McDougall Township, there is not a large enough population to provide statistically-significant data. So while these cancer statistics are interesting, they will neither prove nor disprove that there are higher concentrations (rates of illness) and never will.

So, what now? How can you ever prove that environmental contamination affects the cancer incidences in Nobel, Parry Sound or the surrounding area?

This is why lay knowledge (the scientific way of saying local knowledge among residential populations) and citizen science is so valuable in the eyes of academia. Citizen science is the collection and analysis of research data relating to the natural world by members of the general public (amateur scientists or non-professionals), typically as part of a collaborative project with professional scientists.

One example of a citizen science initiative in Parry Sound is the Mill Lake Guarding Association (MLGA). Its mission is to protect and preserve Mill Lake. One of the founders was concerned about the high cancer incidence rates in Parry Sound, the extension of the McDougall landfill and its impact on Mill Lake, which was how the MLGA came into existence. A member of the MLGA Board of Directors, a non-professional environmental scientist, takes water samples annually.

The impact of citizen science is far-reaching as it enforces accountability. Citizen science combined with lay knowledge is a force to be reckoned with. In the world of academia and scientific study, your local stories and knowledge are powerful. Do not underestimate them.

If you have noticed among your social circles that there are high occurrences of cancer, autism, learning disabilities, miscarriages, fertility issues or other chronic illnesses that may be a result of exposure to endocrine disrupting chemicals, you have the power to do something about it.

In order to determine if the cause is environmental you must look for and test the source.

In the legal case studies (see the section below: “Moving Forward: Further Research and Legal Cases”) you can see how residents connected and were compensated for environmental contamination affecting other local health populations.

In the case of CIL/DIL, you would first have to test for endocrine disruptors in the sediment (soil), water and groundwater. Through the information in this document, you now know where the hotspots or the potential sources exist. You have both lay knowledge and the knowledge of where to begin testing.

How do you test? While citizen science is an effective method of scientific study, when it comes to environmental testing, it is best to have input from experts so that the testing methods are professional and taken properly, thereby ensuring accurate results. This is important, especially when you consider how expensive some of these environmental tests are.

If you decide to continue this investigative research and collect samples, you have the support of Gumption’s wide-ranging professional network, if you choose to request them and pursue some of the answers I know many people in Nobel, Parry Sound and the surrounding area who have been longing for this to happen.