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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.

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