The Alberta Cancer Board did a rigorous study that was reviewed by peer reviewers from across the world on the methods used and the results. Every single peer review is published on public websites. You can read the reviewers' comments on the study.
We at Health Canada have concurred with the findings of this study. We believe the number of cases is definitely within the expected range. First nation cancer rates are usually below the provincial average for cancers across Alberta, except for cholangiocarcinoma. Cholangiocarcinoma is known to be higher in native Americans and indigenous people around the world, and in Alberta the rate of cholangiocarcinoma is two to three times higher than for the rest of Albertans.
So it definitely is the case that it is within the expected range. The fact that two cases happened one after the other in the next year is probably, likely, due to random variation and chance because of the small size of the population.
As for the colon cancer, the physician submitted 12 cases of colon cancer that he said he'd seen. From the 12 he submitted, only three were confirmed to be colon cancers. Because of the rigorous work of the Alberta Cancer Board, they found another three that he had not submitted.
There definitely are small increases in the rates of the other cancers that the board reviewed--blood cancers, lymphatic cancers, soft tissue carcinomas. However, even for those cancers, these are the number of cancers, not the number of people. Some people have actually more than one cancer.
I submit to you that the findings are valid. They have been very well reviewed by independent people. They're the cancers we need to follow. That's why we at Health Canada concur that we need to continue monitoring the cancer incidence.
If these rare cancers happen again, that truly will be a cause for concern and follow-up in a more rigorous way. That's why the Alberta Cancer Board has made a great effort to visit the community and sit down with the local physician who currently is actually reporting cancers. Dr. O'Connor did not report these cancers when they happened. Now this current physician has the form, and he currently reports everything to the board.
I submit to you that the next step, for sure, is to continue monitoring closely to see whether these are true increases in rates or these are true random variations, as many cluster investigations like these have found around the world.