Colorectal Cancer Screening Among Métis and Non-Métis Males and Females in Alberta, Canada

Introduction Colorectal cancer (CRC) screening is an important strategy to reduce morbidity and mortality of cancer. However, evidence on CRC screening and outcomes among Métis people is limited and results are often conflicting. Methods This retrospective study examined CRC screening participation and retention rates, abnormal fecal test results, follow-up colonoscopy rates and wait times, and invasive CRC detection rates and distribution according to Métis status (Métis, non-Métis) and sex (male, female) from 2014 to 2022 among adults living in Alberta. Multiple administrative health databases were linked to investigate study outcomes. Adults aged 50 to 74 years who were eligible for CRC screening were included. Chi-square tests of independence and z- tests compared screening indicators between Métis and non-Métis people and between males and females within each subpopulation. Data over time and across age groups were plotted in scatter plots, and trends were assessed using Joinpoint models. Results CRC screening participation rates among Métis males and females remained slightly higher than, or similar to, their non-Métis counterparts. However, retention rates among Métis people were lower compared to non - Métis people. Comparing females and males, participation rates were higher among females while retention rates were higher among males. A higher proportion of Métis people had abnormal FIT results than their non-Métis counterparts. There were no significant differences in invasive CRC detection rates or CRC stage distribution at diagnosis between Métis and non - Métis people. Conclusion Findings from this study highlight the need for ongoing collaboration among Indigenous leaders, researchers, and healthcare services to support ongoing participation in CRC screening among Métis people.