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BACKGROUND: The Public Health Agency of Canada’s integrated bio-behavioural surveillance system—Tracks surveys—assesses the burden of HIV, hepatitis C and associated risks in key populations in Canada. From 2018–2020, Tracks surveys were successfully implemented by First Nations Health Services Organizations in Alberta and Saskatchewan. METHODS: First Nations-led survey teams invited community members who identified as First Nations, Inuit or Métis to participate in Tracks surveys and testing for HIV, hepatitis C and syphilis. Information was collected on social determinants of health, use of prevention services, substance use, sexual behaviours and care for HIV and hepatitis C. Descriptive statistics are presented. RESULTS: Of the 1,828 survey participants, 97.4% self-identified as First Nations and 91.4% lived in an on-reserve community. Over half (52.2%) were cisgender female, average age was 36.3 years, 82.5% lived in stable housing, 82% had access to primary healthcare and 73.8% reported having good to excellent mental health. Most participants (97%) had a family member who had experienced residential school. High proportions experienced stigma and discrimination (65.6%), financial strain (64.3%) and abuse in childhood (65.1%). Testing for HIV (62.8%) and hepatitis C (55.3%) was relatively high. Prevalence of HIV was 1.6% (of whom 64% knew their infection status). Hepatitis C ribonucleic acid prevalence was 5% (44.9% of whom knew their current infection status). CONCLUSION: Historical and ongoing experiences of trauma, and higher prevalence of hepatitis C were identified, reaffirming evidence of the ongoing legacies of colonialism, Indian Residential Schools and systemic racism. High participation in sexually transmitted blood-borne infection testing and prevention reflect the importance of First Nations-led culturally sensitive, safe and responsive healthcare services and programs to effect improved outcomes for First Nations peoples.

Objective: To determine the clinical validity of family history (FH) in colorectal cancer (CRC) risk classification. Methods: The Assessment of Risk of Colon Tumors In Canada case-control dataset was used to develop regression models associating risk factors with CRC in Ontario adults. Two regression models (‘clinically-driven’ based on a previously published tool, and data-driven) examined discrimination between CRC cases and controls, with and without the inclusion of FH as a risk variable. Discrimination was assessed using the area under the receiver operator characteristics curve. Results: For males, with the addition of FH, there were statistically significant yet quantitatively modest improvements in both models (3.7% clinically-driven, 6.8% data-driven). For females, while FH was a statistically significant predictor of CRC status in the data-driven model, the improvement in discrimination was not significant in either model. Conclusion: FH provides very small improvement in model discrimination beyond other standard CRC risk factors.