Health

Indigenous men diagnosed with more advanced prostate cancer, Canadian study says

Published

1 year ago

July 10, 2023

Indigenous men have more serious and later-stage prostate cancer when they’re diagnosed than non-Indigenous men, a new Canadian study says.

“It is very clear from this data that Indigenous men are at higher risk of developing aggressive prostate cancer than non-Indigenous men,” said Dr. Adam Kinnaird, senior author of the study and the Frank and Carla Sojonky Chair in Prostate Cancer Research at the University of Alberta.

The study, published Monday in the journal Cancer, looked at prostate cancer screening data among almost 1.5 million men in Alberta between 2014 and 2022. They were all between 50 and 70 years old.

Using postal codes, the researchers found that men in First Nations and Métis communities were much less likely to have had a prostate-specific antigen (PSA) test — the method used to screen for prostate cancer — than men living outside of Indigenous communities.

“Non-Indigenous men are having their PSA test done 50 per cent more often than Indigenous men are. And that’s a pretty big difference,” Kinnaird said.

The lack of screening, he said, could be a contributing factor to the study’s other major finding — that at the time of diagnosis, prostate cancer in Indigenous men was more advanced and more aggressive than in non-Indigenous men.

That finding was based on the tumour characteristics of 6,049 men diagnosed with prostate cancer who were seen at urology referral centres at the University of Alberta in Edmonton and at the University of Calgary.

Dr. Jason Pennington, a surgeon at the Scarborough Health Network and the Indigenous lead for the Central East Regional Cancer Program in Ontario, said the results are “not surprising.”

“(They are) actually supporting findings that we’ve been getting from Ontario,” said Pennington, who was not involved in the study and is a member of the Huron-Wendat Nation.

“This is what we see across Canada and across Indigenous populations around the world.”

One weakness of the study, Kinnaird said, is that because it relied on postal codes, it couldn’t compare the rate of PSA testing between Indigenous and non-Indigenous men living in cities.

About half of the Indigenous population lives in cities, he said, and researchers will be looking at data in another Alberta study to try to find testing rates for urban Indigenous men.

Kinnaird’s team also plans additional research to determine whether or not there might be a genetic factor that could make Indigenous men more prone to aggressive prostate cancer, he said.

That’s something that occurs in the Ashkenazi Jewish population, he said.

The study did not look at whether or not prostate cancer was more or less prevalent overall among Indigenous men — just at screening rates and severity at diagnosis.

There are many possible reasons Indigenous men are both tested less and suffer more advanced prostate cancer, Pennington said.

Lack of access to a primary-care provider to get screened is a likely factor, he said, along with social determinants of health, such as poverty, which could make it difficult for someone to take time off work to get a PSA test.

Kinnaird said it’s critical that health-care providers are aware of the inequity of prostate cancer screening.

“It’s something that’s important for Indigenous men, for family physicians, for nurse practitioners and for urologists to bear in mind that when you are seeing an Indigenous man in your clinic that you are really thinking about whether you need to screen for prostate cancer,” he said.

Indigenous distrust of the health-care system is another potential factor behind lower screening rates, Pennington said.

“Every Indigenous person I know, every Indigenous family I know, has had negative experiences in our health-care system,” he said.

One promising solution is holding community screening days, Pennington said, where Indigenous “patient navigators” and Indigenous nursing staff are present to answer questions and provide a culturally safe environment. Families can go together to help them feel more comfortable, he said.

That approach also works in remote Indigenous communities with mobile screening buses, he said.

Pennington said the time has come to implement more of these types of culturally safe Indigenous strategies and measure their success.

“We’re starting to have quite a bit of evidence now regarding the lower screening, the higher stages (of cancer), the poor outcomes,” he said.

“It’s about time we start doing something about it.”

This report by The Canadian Press was first published July 10, 2023.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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Health

Health-care announcements expected with two weeks to go in N.B. election race

Published

1 week ago

October 7, 2024

Anne Joseph

New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.

Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.

A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.

Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.

On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.

While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.

This report by The Canadian Press was first published Oct. 7, 2024.

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Health

Alberta Health Services’ snag leads to potential delay of patient referrals

Published

1 week ago

October 5, 2024

Anne Joseph

EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.

The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.

The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.

She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.

The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.

The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.

This report by The Canadian Press was first published Oct. 4, 2024.

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Health

Don’t fall for fake dentists offering veneers and other dental work on social media

Published

1 week ago

October 5, 2024

Anne Joseph

WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.

But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.

These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.

It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.

On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.

Here’s what to know about veneers and how to avoid bogus providers and services:

What are dental veneers?

Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.

Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.

Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.

In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.

“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”

What are the risks of getting veneers from someone who isn’t licensed?

Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.

Patients need to be anesthetized before the enamel is removed from their teeth.

“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”

One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.

“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.

Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.

How can I spot bogus veneer providers online?

One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”

Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.

Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.

Performing dental work without an appropriate license is illegal, the ADA notes.

Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.

Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.

What are the best ways to find legitimate dental providers?

The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.

“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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