# Yukon Cancer Incidence Report, 2013-2022

###
Government of Yukon, Population and Public Health, Evidence and Evaluation

# Introduction

The Yukon Cancer Incidence Report, 2013-2022, presents a summary of cancer information to help us understand the presence of cancer in the Yukon. This report provides a detailed summary of cancer incidence and trends, including the rate of new cases of cancer. This report aims to examine the landscape of cancer types, distribution among females and males, age at diagnosis, and cancer stage at diagnosis. The content of this report will be useful for health professionals and policy-makers, when making decisions about cancer control and prevention in the Yukon. Members of the public, the media, and educators with an interest in cancer may find value in this report as well. Yukon cancer data available for this report is from the Yukon Cancer Registry, which is a population-based registry of all cancer cases diagnosed among Yukon residents.

# How to use this report

This is an interactive surveillance report. For additional data, hover your cursor over a bar or line on a figure. Drop down functions on several figures also allow the user to view data for a certain cancer site or sex.

# Summary

## All cancer incidence

Between 2013 and 2022, 1719 cases of cancer were diagnosed in the Yukon. An average of 77 (in females) and 95 (in males) new cancer cases were diagnosed annually in the Yukon. It is important to consider that the COVID-19 pandemic influenced the cancer diagnoses, driven by differences in healthcare seeking behaviours, availability and access to healthcare services. Compared to the Canadian rates, the number of new diagnoses appeared similar to the territory [1]. The number of individuals diagnosed with cancer is expected to increase with the growing and aging population, and will have implications on health care demands across Canada.

## Most common cancers

Among all new cancer cases diagnosed in the Yukon, the four most common cancers diagnosed were female breast, colorectal, lung, and prostate. These four cancers are also the most common cancers diagnosed across Canada [1]. This report includes stage of cancer at diagnoses. Early detection for some cancers may lead to better outcomes, and clinicians and health planners may benefit from the the stage at diagnosis distribution for planning health care resources.

## Breast cancer

Female breast cancer rates from 2013-2022 were similar in the Yukon and Canada [1], although more variability in case counts results in unstable rates in the territory due to the small population. Most breast cancer cases in the Yukon were diagnosed among the 50-74 age group, and were predominantly diagnosed at stage one. Early detection factors include breast cancer screening programs, public awareness of symptoms, and access to primary care for women with symptoms.

## Colorectal cancer

Out of all cancer cases diagnosed among men and women, colorectal cancer is the second most common cancer diagnosed among men, and is the third among women. Aside from an expected increase in colorectal cancer cases diagnosed with the roll out of the ColonCheck screening program, cancer rates have been similar to Canada [1]. Most colorectal cancer cases were diagnosed between stage three, two, and four, respectively, and are mainly between the ages of 50-74.

## Lung cancer

Out of all cancer cases diagnosed among men and women, the proportion of lung cancer cases was similar, although was the second most common among women and the third most common among men. Lung cancer rates in the Yukon have been similar to the rates across Canada [1]. Most cases diagnosed in the Yukon were stage four, three, and one, respectively. Earlier stage at diagnosis is associated with better outcomes. Stage at diagnosis is similar to that across Canada.

In the Yukon, approximately 19.5% of the population self-reported as being a current (daily or occasional) smoker in 2022, which is an important risk factor for lung cancer. The self-reported smoking estimate in the Yukon is approximately 10% higher than the Canadian self-reported smoking estimate. Among non-smokers, radon exposure is the leading cause of lung cancer, while smokers face an even higher risk as radon exposure amplifies their likelihood of developing lung cancer.

For smoking cessation supports, Quitpath is an evidence-based smoking, vaping (nicotine), and commercial tobacco cessation program that offers free coaching and nicotine replacement therapy to all Yukon communities.

## Cancer incidence by Yukon regional populations

All-cancer incidence rates, adjusted for the size and age of the population, appeared similar among the rural and urban populations in the Yukon over recent years. This is a change from the previous cancer incidence report, that found rural populations appeared to have a slightly higher cancer incidence rate compared to the Yukon population residing in Whitehorse.

# All-cancer incidence cases

From 2013 to 2022, a total of 1719 cases of cancer were diagnosed in the Yukon. An average of 77 and 95 new cancer cases were diagnosed annually among females and males in the Yukon, respectively (Figure 1). The annual number of cases ranged from 50 to 104 among females, and 73 to 111 among males. The yearly variation may be attributed to the small population of the Yukon and small case counts.

#### Figure 1. Number of New Cancer Cases by Sex and Year, 2013-2022

###### Notes: Excludes non-melanoma skin cancers (neoplasms, NOS; epithelial neoplasms, NOS; and basal and squamous).

# All-cancer incidence rates

Cancer incidence rates were adjusted for age of the population, which is important because cancer risk varies significantly with age. Age-standardized incidence rates (ASIRs) provide a more accurate measure of cancer burden across populations by accounting for differences in age distribution. To stabilize year-to-year variability due to the small number of cases, rolling four-year ASIRs and counts of cancer cases for 2013 through 2022 are shown in Figure 2a.

Incidence rates appear to be on the decline, although the years influenced by the COVID-19 pandemic (2020-2022) may not be truly reflective of the presence of cancer in Yukon residents. The changes seen for years including 2019 to 2022 may be attributable to deferred access to care as COVID-19 restrictions were gradually lifted over the period of time.

#### Figure 2a. Rolling All-Cancer Age-Standardized Incidence Rates by Sex, 2013-2022

###### Notes: Excludes non-melanoma skin cancers (neoplasms, NOS; epithelial neoplasms, NOS; and basal and squamous).

Figure 2b shows the ASIRs by sex and year for the Yukon and Canada. Data for Canada is only available until 2019 [1]. The all-cancer ASIRs for the Yukon did not show a statistically significant change over time, or from the Canadian rates. The variation in rates at the Yukon level are due to small numbers, but the overall trend appears to align with the declining trends at the national level.

#### Figure 2b. All-Cancer Age-Standardized Incidence Rates by Sex and Year, Yukon and Canada, 2013-2022

###### Notes: Data for Canada is only available up to 2019. Excludes non-melanoma skin cancers (neoplasms, NOS; epithelial neoplasms, NOS; and basal and squamous). Shaded areas in Figure 2b represent the 95% confidence intervals (CIs), indicating the range of values within which we are 95% confident the true rate lies.

# Most common cancers in the Yukon

From 2013 to 2022, the most common cancers diagnosed in the Yukon, accounting for 52.8% of the new cancer cases, were female breast, prostate, colorectal, and lung. Other cancer types accounted for 47.2% of new cancer cases diagnosed. This includes a category summarizing several less common cancer types, which together made up 7.8% of new cancer cases diagnosed. Other common cancer types diagnosed in the Yukon included Non-Hodgkin Lymphoma (NHL) (4.5%), head and neck (4.4%), and kidney (2.8%). Other less common types of cancers have been diagnosed in the Yukon, but numbers are too small to report on.

Figure 3 shows the proportion of each of the top cancers out of all cancer cases diagnosed in the Yukon by sex. Among females, the most common were female breast, lung, and colorectal. Among males, the most common were prostate, colorectal, and lung. The same four cancers were the most commonly diagnosed across Canada [1].

#### Figure 3. Most Common Cancers Diagnosed in the Yukon, by sex, 2013-2022

###### Notes: Proportions cannot be compared between groups for statistical meaning, as differences in the populations can distort the interpretation. The proportion can provide insight into the relative distribution.

# Trends by cancer type

The ASIRs for the most common cancer types diagnosed in the Yukon and Canada are shown below in Figure 4. Female breast cancer has been relatively stable in Canada [1], and despite the variability in the Yukon, no changes were statistically significant. Colorectal cancer has been on the decline in Canada from 2013-2019, and aside from a spike in 2018, rates have been similar in the Yukon. The spike in colorectal cancers diagnosed in the Yukon in 2018 may be attributable to increased colorectal screening through the ColonCheck screening access in the territory. Lung cancer rates in Canada declined overall from 2013 to 2019. Lung cancer rates in the Yukon have fluctuated over the period of 2013-2022, including a decline in 2014 before returning to rates similar to Canada. Nationally, prostate cancer was on the rise from 2015-2018, with a drop in 2019. In the Yukon, rates have varied since 2013, but have been similar the Canadian prostate cancer rates (Figure 4).

#### Figure 4. Age-Standardized Incidence Rates for Common Cancer Types, Yukon and Canada, 2013-2022

###### Notes: Data for Canada is only available up to 2019. Excludes non-melanoma skin cancers (neoplasms, NOS; epithelial neoplasms, NOS; and basal and squamous). Shaded areas in Figure 4 represent the 95% confidence intervals (CIs), indicating the range of values within which we are 95% confident the true rate lies.

# All-cancer incidence by sex and age groups

From 2013 to 2022, the Yukon population grew from 36,473 to 44,535 [3]. Cancer incidence rates vary between sex and age groups. Looking at cancer incidence by sex and age can provide a sense of who in a population is developing cancer, and can inform planning for cancer prevention, early detection, and health care services.

#### Figure 5. Distribution of Yukon Population by Age and Sex, 2013-2022

Between 2013 and 2022, 55.0% of all cancer cases diagnosed were among males, and 45.0% were among females (Figure 6).

Cancer primarily affects older people, particularly Canadians over the age of 50 [1]. Over the 10-year period of 2013-2022, 88.0% of all new cancer cases in the Yukon occurred among people age 50 years and older. The distribution of age groups provides insight of what age groups are diagnosed with cancer, but does not indicate whether incidence rate by age group are different than national rates.

Proportions of age at diagnosis by sex are shown in Figure 6. Proportions of age at diagnoses for all cancer incidence was similar between females and males. All cancer incidence among all age groups was similar to what we would expect relative to Canadian rates.

#### Figure 6. Percent Distribution of Cancer Incidence for Groups by Sex and Age, 2013-2022

###### Notes: Excludes non-melanoma skin cancers (neoplasms, NOS; epithelial neoplasms, NOS; and basal and squamous). Proportions cannot be compared between groups for statistical meaning, as differences in the population can distort the interpretation. The proportion can provide insight into the relative distribution.

# Cancer incidence by age for screenable cancers

Cancer incidence with specific age groups for cancers that have screening guidelines, including breast and colorectal, are shown in Table 1 and 2, respectively. Cervical cancer screening is also available in the Yukon; however, the number of cervical cancer cases were too small for meaningful analysis. Screening recommendations are published by Canadian Task Force on Preventive Health Care (CTFPHC) [2], and integrated in the Yukon. Examining incidence by age groups for cancers with screening guidelines is useful for understanding the proportion of cancers that were diagnosed within the recommended age groups for screening. This information can assist in evaluating current screening access and guiding future screening programs in the Yukon.

### Breast cancer

Female breast cancer is the most commonly diagnosed cancer among females in the Yukon, as well as among all Canadian women [1]. Women aged 50-74 are recommended for routine screening with mammography every 1 to 2 years, based on risk. Women aged 40-49, if high risk, are also recommended for routine screening with mammography [2].

From 2013 to 2022, 244 cases of female breast cancer cases were diagnosed in the Yukon (Table 3). The majority of cases were among the screening age group of 50-74; however, collectively 27% of cases were diagnosed outside of standard screening age, including 12.3% among the 40-49 age group. While breast cancer screening primarily identifies cases within the recommended age groups, some individuals were diagnosed outside these guidelines, likely due to suspicious symptoms.

#### Table 1. Number and Proportion of Female Breast Cancer Cases by Age, 2013-2022

Age Group | Cases | Proportion (%)
--- | --- | ---
20-39 | 9 | 3.69
40-49 | 30 | 12.30
50-74 | 176 | 72.13
75+ | 29 | 11.89
Total | 244 | 100.00

### Colorectal cancer

Colorectal cancer is the second and third most common cancer in the Yukon by males and females, respectively. Similarly, colorectal cancer is the third most commonly diagnosed across Canada [1]. The decline observed in Canada over the past few decades is partially attributed to colorectal screening, which can identify precancerous lesions which when treated can prevent cancer and reduce the incidence of cancer in a population. A decrease in mortality is related to the decrease in incidence and improvements in screening, diagnosis, and treatment options.

CTFPHC guidelines suggest that adults age 50-74 should receive screening [2]. ColonCheck Yukon is a colorectal cancer screening program aimed at early detection of pre-cancerous lesions among average risk adults in the Yukon. Screening is available using Fecal Immunochemical Test (FIT), which is a type of Fecal Occult Blood Test (FOBT), and is a take-home test that can detect early signs of colon cancer.

Over the 10-year period of 2013-2022, most colorectal cancer cases were diagnosed in individuals age 50-74. Colorectal cancer screening detects cases within the recommended screening age groups, though some individuals were diagnosed outside these guidelines, likely after developing symptoms.

#### Table 2. Number and Proportion of Colorectal cancer Cases by Age, 2013-2022

Age Group | Cases | Proportion (%)
--- | --- | ---
20-49 | 20 | 8.55
50-74 | 158 | 67.52
75+ | 56 | 23.93
Total | 234 | 100.00

# Cancer stage at diagnosis for select cancers

Figures 7, 8, and 9 show the stage distribution of female breast, colorectal, and lung cancers, respectively. Although cervical cancer screening is available through providers in the Yukon, the cancer case count is too small to report on at the stage level. Staging data is only presented from 2018 to 2022 to reflect a change in stage reporting from prior years.

Stage at diagnosis is useful in understanding treatment options and outcomes, as well as planning for health care resource demand. Understanding the landscape of stage at diagnosis also highlights areas where efforts in screening may be needed. For example, if routinely screened cancer has low uptake and is primarily being diagnosed at late stage, efforts to increase screening access may help shift the distribution of stage at diagnosis to an earlier and more treatable stage.

Stage unknown indicates that not enough information was provided to accurately stage the cancer. For 2018 onwards, the American Joint Committee on Cancer (AJCC) TNM8 staging system is used [4]. Staging for prostate cancer is not included in this report due to the high number of stage unknown classifications.

#### Figure 7. Female Breast Cancer Percent Stage Distribution, 2018-2022

#### Figure 8. Colorectal cancer Percent Stage Distribution by Sex, 2018-2022

###### Notes: Proportions or percentages cannot be compared between groupsfor statistical meaning, as differences in the population can distort the interpretation. Proportions can provide insight into the relative distribution.

#### Figure 9. Lung Cancer Percent Stage Distribution by Sex, 2018-2022

###### Notes: Proportions or percentages cannot be compared between groupsfor statistical meaning, as differences in the population can distort the interpretation. Proportions can provide insight into the relative distribution.

# Cancer incidence by Yukon regional populations

In the mid-year of the analysis period (2013-2022), 2017, approximately three-quarters of the population lived in and around Whitehorse and the surrounding areas, while the other quarter of the population resided in the rural areas [3]. In this section, we examine all-cancer incidence by different population areas, based on place of residence.

From 2013 to 2022, there were 1719 new cases of cancer diagnosed in the Yukon, of which 72.5% were among urban residence and 27.5% were among rural residents, respectively (Figure 10). During the 2013-2016 rolling period, the rural population had a statistically significantly higher ASIR compared to the urban population. In subsequent rolling periods, there were no statistically significant difference in ASIRS between the rural and urban populations in the Yukon. The same four cancers were most common between the urban and rural populations in the Yukon: colorectal, breast, lung, and prostate.

#### Figure 10. All-Cancer Age-Standardized Incidence Rates by Yukon Regional Population, 2013-2022

###### Notes: The vertical lines associated with each data point in Figure 10 represent the 95% confidence intervals (CIs), indicating the range of values within which we are 95% confident the true rate lies. Where the lines for urban and rural data do not overlap, there is a statistically significant difference between the rates. For 2016 through 2022 data, there is a gap in the information provided by Vital Statistics and the Discharge Abstract Database, which are used to identify additional cancer cases. Please use caution when interpreting counts, proportions, and rates.

# About this report

#### Yukon Cancer Registry

The Yukon Cancer Registry is a population-based registry of all cancer cases diagnosed among Yukon residents. The purpose of the registry is to gather information required to develop and evaluate cancer case and prevention initiatives in the territory. The Yukon Cancer Registry, built in 1987, is overseen by the Department of Health and Social Services within the Yukon Government, which contracts BC Cancer to build and maintain a separate territorial registry within its cancer registry infrastructure.

The registry receives notifications of cancer diagnoses from various sources, including diagnostic laboratories and health care providers. For 2016 through 2022 data, there is a gap in the information provided by Vital Statistics and the Discharge Abstract Database, which are used to identify additional cancer cases. Please use caution when interpreting counts, proportions, and rates.

Within the registry, personal and demographic, specific cancer diagnoses, and some mortality information are held to support analyses of Yukon cancer data. Nationally, cancer registries are used to generate statistics about cancer to describe trends and jurisdictional differences in cancer incidence and mortality. This data is also used to project future diagnoses, service needs, evaluate the effectiveness of cancer control programs, and support patient experiences and outcomes. Further, data generated are used to support valuable research into causes, prevention, screening, diagnoses, clinical management, and treatment of cancer, in addition to projecting the demand on the public health care system.

#### Cautions on interpretation

Due to the small number of cases and the population size in the Yukon, the rates presented in this report should be interpreted with caution due to high variability. As cases are categorized by different characteristics, such as age or sex, the case numbers in the sub-category decrease substantially, which results in imprecise rates for the small groups. To address the potential uncertainty, data for some analyses were aggregated, such as combining multiple years of cases or presenting rates for both sexes combined. Aggregated estimates may not truly be reflective of the current estimates, and readers should consider the period and number of cases when interpreting the data.

#### Scope of this report

The most up-to-date cancer statistics information in the Yukon is conveyed in this surveillance report. Accurate reporting of cancers is smaller jurisdictions is especially important, such as in the Yukon, because small changes have the potential to have a big impact on rates. Where there were small case counts, years were aggregated to provide more reliable rates. This report only contains cancer incidence among residents of the Yukon, meaning an individual who moved away from the territory before a cancer diagnosis would not be included.

#### Confidentiality and small numbers

To prevent the potential identification of individuals who have received a cancer diagnosis, this report presents data where cell counts are five or more. Smaller counts can occur for rare cancers, or when stratifying (such as by age, sex, or year). For regional level analysis, cell counts less than ten were suppressed.

#### Sex, gender, and ethnicity

The Yukon Cancer Registry does not contain a gender identity variable, meaning the data presented is only stratified by sex at birth. Where possible, statistics were stratified by sex, as cancer impacts females and males differently. Further, there is no ethnicity identifier in the registry. Not reporting on gender and ethnicity limits us building on the understanding of the cancer landscape in the Yukon, and the potential relationships between cancer diagnosis and social or cultural factors. These factors include barriers to screening, prevention, and care, the social determinants of cancer, differences in the modifiable behavioural factors, attitudes towards health, and cultural influences.

#### Yukon First Nations

This report does not contain Yukon First Nations identifiers, and does not comment on the cancer cases or rates among Yukon First Nations. The Yukon Cancer Registry does not contain a First Nations identifier variable. We acknowledge that this is an important area of interest identified by Yukon First Nations governments, and is a key component of the work and discussions happening within the Yukon First Nations Cancer Care Project.

# References

[1] Statistics Canada. Table 13-10-0747-01 Number of new cases and age-standardized rates of primary cancer, by cancer type and sex DOI: https://doi.org/10.25318/1310074701-eng

[2] Canadian Task Force on Preventive Health Care. Published guidelines. Retrieved March 6, 2025, from https://canadiantaskforce.ca/guidelines/published-guidelines/

[3] Yukon Bureau of Statistics. (2023, May). Population Report, First Quarter, 2023. https://yukon.ca/sites/yukon.ca/files/ybs/fin-population-report-q12023.pdf https://yukon.ca/sites/yukon.ca/files/ybs/fin-population-report-q12023.pdf

[4] Union for International Cancer Control (UICC). TNM classification of malignant tumours (8th edition). Retrieved March 6, 2025, from https://www.uicc.org/resources/tnm-classification-malignant-tumours-8th-edition