Dr. Caron is an advocate for marginalized peoples’ rights in health care and research. Her scholarly and professional activities centre on optimizing Indigenous and northern Canadians’ health, and addressing inequities in access to surgical services, cancer care, prescription medications and research.

In January 2020, Dr. Caron was appointed the inaugural First Nations Health Authority (FNHA) Chair in Cancer and Wellness at University of British Columbia. In this position, Dr. Caron is developing strategies to better understand, prevent and address cancers among Indigenous peoples in Canada. This position was created following research led by Dr. Caron that illustrated how rates of some cancers are higher, and survival rates for almost all cancer types, lower, for First Nations compared with non-First Nations in British Columbia. This research underpins B.C’s First Nations Cancer Strategy—a multi-year partnership between BC Cancer, FNHA, Métis Nation British Columbia and the BC Association of Aboriginal Friendship Centres.

As co-Lead of Genome Canada’s $10.4 million Silent Genomes grant, which commenced in 2018, Dr. Caron aims to address inequity endured by Indigenous peoples who lack access to the medical benefits of genome research. To do so, her team is establishing guidelines for genomic research with Indigenous peoples, developing project-specific governance structures, improving access to and impact of precision medicine by creating an Indigenous background variant library and evaluating the impacts of these efforts from a socio-economic lens.



In 2016, Dr. Caron received $1.25 million from Genome British Columbia for the Northern Biobank Initiative to address a growing risk that rural and remote communities in B.C. could be excluded from significant advances made in genomic research and precision medicine. The NBI project includes consultations with the general public, researchers, health care providers, staff, and administrators; creation of a retrospective Northern B.C. Breast Cancer biobank, and consultations with 54 First Nations, including development of the Northern First Nation Biobanking Advisory Committee.

In 2014, Dr. Caron helped to found and now co-directs UBC’s Centre for Excellence in Indigenous Health in order to improve recruitment and retention of Indigenous students into health professions, to develop curricula addressing Indigenous health concerns, and to conduct further research into Indigenous health in general. This initiative has resulted in a cultural safety and humility curriculum for UBC students and a graduate certificate in Indigenous Public Health that equips Indigenous community members and scholars with necessary skills to address public health issues in First Nations, Inuit, Métis and other Indigenous communities. Dr. Caron also teaches at Johns Hopkins University, Center for American Indian Health, where her curriculum incorporates research ethics, cultural competency and public health through an Indigenous lens.

Affiliations
  • General and Endocrine Surgeon, University Hospital of Northern BC
  • Professor, Surgery, University of British Columbia, Northern Medical Program and Department of Surgery
  • Founding Co-Director, University of British Columbia, Centre for Excellence in Indigenous Health
  • First Nations Health Authority Chair in Cancer and Wellness at University of British Columbia
  • Associate Faculty, Johns Hopkins University, Center for American Indian Health
Credentials

FRCSC, General Surgery Residency University of British Columbia
Postgraduate Fellowship in Endocrine Surgical Oncology, University of California, San Francisco
MA in Public Health, Harvard University
MD, University of British Columbia
B.Sc. Kinesiology, Simon Fraser University

Selected Publications

Genomic Research Through an Indigenous Lens: Understanding the Expectations.

Annual review of genomics and human genetics, 2019
Garrison, Nanibaa' A, Hudson, Māui, Ballantyne, Leah L, Garba, Ibrahim, Martinez, Andrew, Taualii, Maile, Arbour, Laura, Caron, Nadine R, Rainie, Stephanie Carroll
Indigenous scholars are leading initiatives to improve access to genetic and genomic research and health care based on their unique cultural contexts and within sovereign-based governance models created and accepted by their peoples. In the past, Indigenous peoples' engagement with genomicresearch was hampered by a lack of standardized guidelines and institutional partnerships, resulting in group harms. This article provides a comparative analysis of research guidelines from Canada, New Zealand, Australia, and the United States that pertain to Indigenous peoples. The goals of the analysis are to identify areas that need attention, support Indigenous-led governance, and promote the development of a model research policy framework for genomic research and health care that has international relevance for Indigenous peoples.

Peripheral artery disease among Indigenous Canadians: What do we know?

Canadian journal of surgery. Journal canadien de chirurgie, 2018
Bonneau, Christopher, Caron, Nadine R., Hussain, Mohamad A., Kayssi, Ahmed, Verma, Subodh, Al-Omran, Mohammed
Indigenous Canadians experience a disproportionate burden of chronic atherosclerotic diseases, including peripheral artery disease (PAD). Despite an estimated prevalence of 800 000 patients with PAD in Canada, the burden of the disease among Indigenous Canadians is unclear. Available evidence suggests that this population has a higher prevalence of several major risk factors associated with PAD (diabetes, smoking and kidney disease). Unique socioeconomic, geographic and systemic obstacles affecting Indigenous Canadians’ health and health care access may worsen chronic disease outcomes. Little is known about the cardiovascular and limb outcomes of Indigenous peoples with PAD. A novel approach via multidisciplinary vascular health teams engaging Indigenous communities in a culturally competent manner may potentially provide optimal vascular care to this population. Further research into the prevalence and outcomes of PAD among Indigenous Canadians is necessary to define the problem and allow development of more ffective initiatives to alleviate the disease burden in this marginalized group.

Measuring cancer in indigenous populations.

Annals of epidemiology, 2018
Sarfati, Diana, Garvey, Gail, Robson, Bridget, Moore, Suzanne, Cunningham, Ruth, Withrow, Diana, Griffiths, Kalinda, Caron, Nadine R, Bray, Freddie
It is estimated that there are 370 million indigenous peoples in 90 countries globally. Indigenous peoples generally face substantial disadvantage and poorer health status compared with nonindigenous peoples. Population-level cancer surveillance provides data to set priorities, inform policies, and monitor progress over time. Measuring the cancer burden of vulnerable subpopulations, particularly indigenous peoples, is problematic. There are a number of practical and methodological issues potentially resulting in substantial underestimation of cancer incidence and mortality rates, and biased survival rates, among indigenous peoples. This, in turn, may result in a deprioritization of cancer-related programs and policies among these populations. This commentary describes key issues relating to cancer surveillance among indigenous populations including 1) suboptimal identification of indigenous populations, 2) numerator-denominator bias, 3) problems with data linkage in survival analysis, and 4) statistical analytic considerations. We suggest solutions that can be implemented to strengthen the visibility of indigenous peoples around the world. These include acknowledgment of the central importance of full engagement of indigenous peoples with all data-related processes, encouraging the use of indigenous identifiers in national and regional data sets and mitigation and/or careful assessment of biases inherent in cancer surveillance methods for indigenous peoples.

Cancer in First Nations people living in British Columbia, Canada: an analysis of incidence and survival from 1993 to 2010.

Cancer causes & control : CCC, 2017
McGahan, Colleen E, Linn, Kevin, Guno, Preston, Johnson, Harmony, Coldman, Andrew J, Spinelli, John J, Caron, Nadine R
For First Nations (FN) peoples living in British Columbia (BC), little is known regarding cancer in the population. The aim of this study was to explore cancer incidence and survival in the FN population of BC and compare it to the non-FN population.

A proposal for the curriculum and evaluation for training rural family physicians in enhanced surgical skills.

Canadian journal of surgery. Journal canadien de chirurgie, 2015
Caron, Nadine, Iglesias, Stuart, Friesen, Randall, Berjat, Vanessa, Humber, Nancy, Falk, Ryan, Prins, Mark, Vogt Haines, Victoria, Geller, Brian, Janke, Fred, Woollard, Robert, Batchelor, Bret, Van Bussel, Jared
Rural western Canada relies heavily on family physicians with enhanced surgical skills (ESS) for surgical services. The recent decision by the College of Family Physicians of Canada (CFPC) to recognize ESS as a "community of practice" section offers a potential home akin to family practice anesthesia and emergency medicine. To our knowledge, however, a skill set for ESS in Canada has never been described formally. In this paper the Curriculum Committee of the National ESS Working Group proposes a generic curriculum for the training and evaluation of the ESS skill set.

Are we homogenising risk factors for public health surveillance? Variability in severe injuries on First Nations reserves in British Columbia, 2001-5.

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 2011
Bell, Nathaniel, Schuurman, Nadine, Hameed, S Morad, Caron, Nadine
Aboriginal Canadians are considered to be at increased risk of injury. The de facto standard for measuring injury risk factors among Aboriginal Canadians is to compare hospitalisation and mortality against non-Aboriginal Canadians, but this may be too broad an approach for injury prevention and public health if it over-generalises injury risk.

Papillary thyroid cancer: surgical management of lymph node metastases.

Current treatment options in oncology, 2005
Caron, Nadine R, Clark, Orlo H
Papillary thyroid cancer (PTC), the most common thyroid malignancy, is associated with cervical lymph node metastases in 30% to 90% of patients. While surgery is the primary treatment modality for PTC, radioactive iodine and thyroid hormone suppression often complement the treatment plan. Although thyroid hormone suppression may decrease the incidence of recurrent disease and radioactive iodine may diagnose and treat metastases, lymph node dissection (LND) is the mainstay treatment for clinically evident cervical lymph node metastases. The surgical treatment options published in the literature include the traditional radical LND, the modified radical LND, the selective LND (compartment-based resection based on documented lymph node metastases), and a 'berry picking' resection (in which only the grossly abnormal lymph nodes are excised). At the University of California, San Francisco, we prefer the modified radical LND with preservation of the cervical sensory nerves for the first lymph node dissection with the 'berry picking' procedure limited to surgical treatment of recurrent nodal metastases in previously resected lymph node basins. Some centers are evaluating the potential role of sentinel lymph node biopsies for PTC. While the extent of lymphadenectomy is debated, most physicians treating patients with PTC agree that clinical evidence of lymphatic metastases should be surgically exercised and there is no role for prophylactic LND.
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