U of T Researchers receive $1.5 million to improve cancer screening among Indigenous People

April 16, 2019

Share Post

In Canada, Indigenous people continue to face persistent health inequities, that are rooted in colonialism and racism. These issues extend to cancer and cancer screening in Ontario, where Indigenous persons report a lack of cultural safety and have have worse outcomes from cancer.

Profile of Jill Tinmouth
Photo by Matthew Pariselli

To improve cancer outcomes and address the disparities faced by Indigenous peoples across Ontario, researchers from the University of Toronto, Sunnybrook Hospital, Cancer Care Ontario (CCO), and Queens University have received a 5-year $1.5 million grant from the Canadian Institutes of Health Research (CIHR), which aims to improve Indigenous cultural safety in cancer screening.

“Research shows, that cancer-related survival is worse among Indigenous people compared to the general population in Ontario,” said Dr. Jill Tinmouth, lead principal investigator on the project and an associate professor at the Institute of Health Policy, Management and Evaluation (IHPME) in the Dalla Lana School of Public Health. “We know that for some cancers, screening is an effective way to prevent the cancer and improve cancer-related survival, yet issues related to poor cultural safety may be contributing to lower screening rates among Indigenous peoples.”

Previous research conducted by Tinmouth, who is also a physician scientist at Sunnybrook Hospital, along with her co-principal investigator on the current grant, Alethea Kewayosh, Director of the Indigenous Cancer Control Unit at Cancer Care Ontario, found that Indigenous participants reported a lack of trust, poor communication, and power imbalances as key barriers in accessing cancer screening.

“The two largest barriers to Indigenous health, racism and access, are not biological or technical processes, they have to do with systems and systemic delivery,” said Suzanne Stewart, Director of the Waakebiness-Bryce Institute for Indigenous Health and a co-researcher on this project.

The project will look specifically at ways to improve access in Cancer Care Ontario’s organized cancer screening programs in breast, cervical, and colorectal cancers. The researchers and their Indigenous partners will focus on three aims: 1) improving cultural safety in the cancer system and working with Indigenous communities 2) establishing culturally safe communication strategies and 3) exploring shared decision-making processes for cancer screening.

Stewart along with IHPME professor Whitney Berta, will be leading the aim focused on improving cultural safety in Ontario’s cancer screening programs, which will include the development of an evidence-informed assessment tool applied to the CCO’s current strategies, alongside interviews with clients/patients, providers/practitioners, and health systems representatives.

“Cultural safety is a care concept that emphasizes respecting cultural differences, demands empathy and self-reflection, and is attentive to empowering the care recipient,” said Berta. “Research suggests that failure to attend to cultural safety can lead to underuse, delayed use or poor access to care services.”

Implementing cultural safety training for service providers particularly in cancer screening, can help to ensure that Indigenous patients do not experience adverse events because of culturally unsafe practices.

“Many Indigenous people feel judged or biased against, and often experience fear that their health condition will be attributed to social factors outside of their control,” said Stewart. “This fear leads them to avoid screening or opt out of treatment and widens the gap in their care that much further.”

Currently CCO sends out millions of letters each year as the primary way of reaching individuals who are due for screening. While effective in the general population, the team’s prior research suggests that this approach to communication may not be working for many Indigenous persons in Ontario. In rural areas for example, letters regarding screenings may never arrive, while some Indigenous people may indicate a preference for receiving health information orally or from a trusted Indigenous community member.

The partnerships that Tinmouth and Kewayosh have developed with Indigenous communities over the past five years are fundamental to the current project and will help to address issues identified by these partners including the need for new communication strategies.

“Addressing how we tackle correspondence and strategizing around the ways in which we can consider our audience, the message and the ways in which it is delivered are all questions we are trying to sort out,” said Tinmouth. “But empowering the recipient of healthcare and addressing issues that we know are important to Indigenous participants, such as the lack of culturally relevant screening education resources and the complexities of getting screened in rural Indigenous communities, are additional ways that we can transform the design of the system so that it will benefit everyone.”

Related News

Clara Ho delivering a speech on equity-driven healthcare leadership at the 2025 CCHL National Conference, standing at a podium with a projected image behind her.

Impact From Within: Clara Ho’s Journey from MHSc to Systemic Change

June 24, 2025

Awards / Students

Read More
A man in a black suit jacket and light-colored shirt stands in front of a blurred building background. The image has colored bars in the corners: blue and purple in the top left, and orange and green in the bottom right.

IHPME Faculty Presented With Insulin Banting Award for Redefining Diabetes Care

June 20, 2025

Faculty / Research

Read More

IHPME Students Recognized as 2025-26 CGS Doctoral Scholars

June 19, 2025

Research / Students

Read More
Black and white photograph of two individuals. The person on the left is wearing a blazer over a dark shirt, and the person on the right has long wavy hair and is wearing a light-colored top. The background is blue with abstract shapes in purple, green, orange, and blue at the corners.

Empowering Future Leaders in Health: Meet the 2025–26 C. David Naylor Fellows

June 9, 2025

Students

Read More
A collage of five headshots, the 2025–26 Vector Scholars, arranged in a 3x3 grid, with alternating colored squares in blue, dark blue, light blue, purple, green, and yellow filling the empty spaces; the individuals have varied hairstyles and clothing.

Advancing the Future of Health Through AI: IHPME Students Recognized with 2025–26 Vector Scholarships

May 29, 2025

Awards / Students

Read More
A digitally altered photo of three people standing side by side with faces obscured by gray rectangles; the background is a blurred, blue-tinted urban scene with colorful bars in orange, green, and purple in the corners.

IHPME-Affiliated Team Looped Advances in AI Competition

May 27, 2025

Faculty / Research / Students

Read More

Sign up for IHPME Connect.

Keep up to date with IHPME’s News & Research, Events & Program, Recognition, e-newsletter.

Subscribe to Connect Newsletter

Get in Contact


Communications

Marielle Boutin
Email Address: ihpme.communications@​utoronto.ca

Manages all IHPME-wide communications and marketing initiatives, including events and announcements.