In 2022, patient organizations, professional associations, and life sciences companies witnessing the magnitude of the problem in our cancer care systems came together to form Cancer Action Now, a national alliance advocating to ensure Canadians have access to high-quality cancer care when and where they need it, towards the goal of improving cancer survivorship in Canada.
Cancer care has reached a crisis point because of widespread disruptions of screening, treatment and surgeries prompted by the COVID-19 pandemic. According to Statistics Canada, in 2020 diagnosis of cancer cases dropped 12.3% lower than the average annual rate over the previous five-year period1, due to Canadians experiencing challenges accessing primary care and screening appointments cancelled. This means more patients now are presenting with advanced stages of cancer, requiring aggressive treatments and more surgeries, adding more pressure and costs to already overburdened health systems.
The pandemic also exacerbated the shortage of health care providers, with 2022 research showing nearly 6 million Canadians don’t have a family doctor, and a third of them have been looking for over a year2. This means fewer people are being referred for screening and investigation of cancer in a timely manner, leading to even more delayed diagnoses, with many cancers detected at a later stage when they are more difficult to treat.
Our cancer care systems were struggling in the years before the pandemic. Now the situation is even worse, and our strategies must evolve in response. Canada needs to urgently address the myriad problems plaguing our health systems across the continuum of care, from primary care to specialist care, to supportive, palliative and end-of-life care. Moreover, the quality of care Canadians receive and how long they need to wait before they receive it, should not depend on which part of the country they live in.
We are calling on your government to implement the three recommendations below to ensure hundreds of thousands of Canadians touched by cancer and their families can access the care they need, where they need it, and live healthier, longer lives than anywhere else in the world.
Recommendation:
Work with provinces and territories, health care providers across the cancer care continuum, patients, caregivers, and equity-deserving groups, with guidance from the federal all-party cancer caucus, to establish a set of common, pan-Canadian standards for cancer care. This will provide an evidence-based framework for care delivery that people in Canada can rely on from coast to coast to coast.
Canada has already made progress with a National Diabetes Framework, National Long-Term Care Services Standard and the ongoing development of National Standards for Mental Health and Substance Use Services.
With dollars committed to this work in the upcoming budget, national standards for cancer care should be developed with the goal of equitably addressing gaps in priority areas, such as, increasing participation in and access to screening programs, reducing time from suspicion to diagnosis, reducing late-stage diagnosis, ensuring improved access to supportive, palliative and end-of-life care, and improving access to and adoption of biomarker testing that can advance effective therapies and improve patient outcomes, among other areas.
Recommendation:
Building on the work done by the Canadian Cancer Society, Canadian Partnership Against Cancer, and the Pan-Canadian Health Data Strategy Expert Advisory Group, invest in the creation and implementation of a pan-Canadian cancer data strategy to ensure accountability in care delivery, interoperability across the continuum of cancer care and transparent reporting on year-over-year progress against specific cancer metrics. This work should involve health care providers across the cancer care continuum, patients, caregivers, and equity-deserving groups to ensure the metrics included and measured lead to tangible improvements in the cancer care system.
Building on the work done by the Canadian Cancer Society, Canadian Partnership Against Cancer, and the Pan-Canadian Health Data Strategy Expert Advisory Group, invest in the creation and implementation of a pan-Canadian cancer data strategy to ensure accountability in care delivery, interoperability across the continuum of cancer care and transparent reporting on year-over-year progress against specific cancer metrics. This work should involve health care providers across the cancer care continuum, patients, caregivers, and equity-deserving groups to ensure the metrics included and measured lead to tangible improvements in the cancer care system.
We call on your government to invest in a cancer care data strategy to improve the timeliness of data capture and availability, establish data quality indicators, ensure cancer data interoperability and integration, fill gaps on social determinants of health data and enhance collection of patient-reported outcomes and experience. It is also vital that your government measure the cost of cancer annually and work in close collaboration with provinces and territories to make progress towards personal health records and improve data sharing between physicians, care teams and patients.
Recommendation:
Work with national organizations and provincial and territorial partners to address access and inequity issues facing the cancer system, such as, access to therapies and innovative, genome-based therapies for cancer care and ensure the quality of care Canadians receive and how long they need to wait before they receive it, does not depend on which part of the country they live in.
With the recognition that science is delivering rapid advances in cancer treatment, which are fundamental to improving outcomes, quality of life and survivorship for Canadians facing cancer diagnoses, especially at late stages, we ask that your government ensure that mechanisms to ensure timely access clinical trials or new cancer treatments be made a priority.
Rural and remote populations in Canada face a variety of barriers in accessing preventative care and treatment, including longer travel times, higher costs, and fewer available healthcare resources. They may be less likely to access or participate in cancer screening programs, may experience lengthy wait times to see specialists, or have to travel outside their jurisdictions to access care.
Canadians participate in a lottery every time they have a brush with the health care system, and it can mean the difference between getting screened for prostate cancer or not, or whether or not you have a better chance of surviving a cancer diagnosis. Addressing this inequity will require concerted action from federal, provincial and territorial governments, informed by the experiences of health care providers across the cancer care continuum, patients, caregivers, and equity-deserving groups that are navigating the cancer care system in different parts of the country.
More silos will only make these challenges worse. The federal government working with jurisdictions can tackle important priorities to improve cancer care in Canada, with particular attention on increasing the availability of primary care for all Canadians, improving data collection, bolstering health human resources, supporting team based interdisciplinary holistic care and ensuring equitable access to screening and treatment for all Canadians, no matter where they live.
Important signs of progress will be when we see more Canadians diagnosed with early-stage cancer, fewer diagnosed with late-stage cancer, and those living with cancer not just surviving but thriving. This will mean our cancer care system is truly responsive to the needs of Canadians it serves.