Project Report

The Wequedong Lodge Cancer Screening Program: implementation of an opportunistic cancer screening pilot program for residents of rural and remote Indigenous communities in Northwestern Ontario, Canada


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Sara Chow1
MPH, BSc, BPHE, Health Promotion and Communications Planner *

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Susan Bale2
Regional Indigenous Cancer Lead Assistant for Northwestern Ontario

Fred Sky3 Lead Supervisor

Shannon Wesley4 MD, MSc, CFPC, Family Physician

Lauren Beach5 BASc, Mobile Coach Lead

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Sarah Hyett6
MSc, Prevention and Screening Services Intern

Tarja Heiskanen7 MRTT, Screening and Assessment Manager

Kelly-Jo Gillis8 MSc, Preventive Health Services Manager

Cathy Paroschy Harris9 RD, MBA, Director of Prevention and Screening Services


1 Prevention and Screening Services Health Promotion and Communications Planner, Thunder Bay Regional Health Sciences Centre, 984 Oliver Road, Medical Centre Room 401, Thunder Bay, ON P7B 6V4, Canada

2 Thunder Bay Regional Health Sciences Centre, 984 Oliver Road, Medical Centre Room 401, Thunder Bay, ON P7B 6V4, Canada

3 Wequedong Lodge, 435 Balmoral Street, Thunder Bay, ON P7C 5N4, Canada

4 Previous address: Regional Indigenous Cancer Leader, Cancer Care Ontario. Current address: Faculty at Northern Ontario School of Medicine; and Aurora Family Health Clinic, 971 Carrick St., Thunder Bay, ON P7B 6L9, Canada

5, 6, 7, 8, 9 Prevention and Screening Services, Thunder Bay Regional Health Sciences Centre, 984 Oliver Road, Medical Centre Room 401, Thunder Bay, ON P7B 6V4, Canada

ACCEPTED: 25 January 2020

early abstract:

Introduction: The rural and remote nature of many First Nations communities in Northwestern Ontario, Canada poses unique obstacles to physically accessing healthcare, in addition to other barriers. Indigenous Peoples face similar challenges globally. First Nations communities experience significant health inequities, including cancer burden, which can be attributed to complex factors associated with colonization and Westernization. One potentially promising intervention to decrease the burden of advanced cancers is the provision of accessible, convenient and culturally sensitive cancer screening services, leading to early detection and treatment. The Wequedong Lodge Cancer Screening Program (WLCSP) was a pilot project aiming to provide cancer screening education and opportunistic cancer screening to residents from rural and remote First Nations communities while accessing health services in the urban centre of Thunder Bay, Ontario, Canada.

Methods: Cancer screening education and opportunistic breast, cervical and colorectal cancer screening appointments were offered to individuals and their travel escorts already staying at Wequedong Lodge (WL). Program uptake was determined primarily by education participation, and secondarily by client participation in screening.

Results: In total, the WLCSP booked 1,033 appointments, with 841 being attended. Over the program’s three years there was an increase in clients each year. Specifically, 22% (60/275) of eligible women completed a mammogram. Pap tests were provided to 8% (45/554) of eligible females. Finally, 32% (106/333) of all eligible service participants were given a Fecal Occult Blood Test (FOBT) kit. An evaluation survey (n=396) demonstrated overall client satisfaction with the program.

Conclusion: The WLCSP aimed to provide education about, access to, and uptake of cancer screening services for First Nations people from rural and remote communities in Northwestern Ontario by targeting inequalities in accessing cancer screening opportunities. Therefore, program uptake may provide helpful numerical comparisons for similar future programs globally. Other entities working to improve cancer screening rates in remote and/or rural populations and/or amongst Indigenous Peoples may find consideration of the WLCSP processes, successes, and challenges helpful to their efforts.