Cancer is an indiscriminate disease, affecting rich and poor, old and young, often for no discernible reason. Still, Canadians’ odds of getting sick or dying depend surprisingly on where they live. Click a particular health region to find out incidence rates (new diagnoses in a year) as well as mortality rates — both per 100,000 and standardized by age — for the major cancers: breast, lung, colorectal and prostate.
Interactive map by Monika Warzecha. Text by Tom Blackwell. Data from Statistics Canada.
Where you live could determine your odds
of getting cancer or dying from it
East versus west: One of the starkest cancer gaps is between Western Canada and the area from Quebec eastward to the Atlantic. Overall incidence rates are generally higher in the eastern half of the country than in the west, and the difference is particularly pronounced with lung and colorectal cancers. Experts point to the relatively high smoking rates in Quebec and Atlantic Canada, and poorer diet in some eastern provinces. But they say variations can also stem from differences in screening programs that detect disease early, like the PSA test for prostate cancer, or simply how jurisdictions document cases.
North versus south: Northern Canada seems to have a serious cancer problem. While age-adjusted incidence rates were similar or lower in the territories compared with the provinces, the proportion of people who die from the disease was significantly higher across the north in 2016, Canadian Cancer Society figures indicate. Smoking and lung cancer’s disproportionately high death toll is again a major factor. Nunavut has reduced tobacco use in recent years but the rates are still sky-high, with 61 per cent of the population over age 12 puffing in 2014, according to federal data. The low incidence but high mortality for colorectal cancer in the north could be linked to screening, which allows the disease to be treated earlier, says the Conference Board of Canada.
Urban versus rural: Living in a big city or a smaller centre can affect people’s chances of getting cancer and surviving it. Canadians in rural and remote areas are more likely to be diagnosed with lung and colorectal cancer, and more likely to die from those cancers and from prostate cancer than people in urban areas, according to a 2014 Canadian Partnership Against Cancer report. Part of the reason is higher smoking and obesity rates in less-urban places. Women in rural areas wait longer to have abnormal mammogram results checked, and a smaller percentage of rural patients undergo radiation, the rate dropping the further they are from a radiation-treatment facility.
Risky places: Getting cancer can seem like a random event, but there are some preventable risk factors. Their impact varies greatly from place to place, more because of personal lifestyle than geographic features. Alcohol consumption is one example. Just 16 per cent of Quebecers reported not having a drink in the previous 12 months, versus 23 per cent in Prince Edward Island, according to the Canadian Partnership Against Cancer. The percentage of obese and overweight adults was 55 per cent in Alberta and 64 per cent in New Brunswick. And eating fruit and vegetables – a key strategy for staving off cancer and other diseases – is a regional phenomenon as well, with 46 per cent of Quebecers reporting they had five or more servings daily in 2014, compared with 26 per cent in Newfoundland.
The treatment gap: The treatment that Canadians get when they’re diagnosed with cancer also depends on where they live. Liver cancer patients in Alberta, for instance, are twice as likely to get potentially curative surgery as those in New Brunswick. Breast cancer patients see even greater differences, with 75 per cent of operations in Quebec being breast-conserving lumpectomies (as opposed to mastectomies) versus under 31 per cent in Newfoundland.