By Dr. Craig Earle, CEO, Canadian Partnership Against Cancer
This past weekend (Feb. 4) marked World Cancer Day, an opportunity to reflect on the extraordinary work underway across Canada to support pandemic recovery and improve cancer prevention and care for all.
The impact of the COVID-19 pandemic on our healthcare and cancer systems has been dire. Healthcare professionals are under pressure. Cancer screening, diagnosis and treatments have been delayed. Important prevention programs, such as school-based HPV immunizations, have been disrupted. Lives are at stake.
In the face of this, the Canadian Partnership Against Cancer (the Partnership) and our partners have been working hard, building on more than 15 years of collaboration to improve the system for everyone in Canada. We are having an impact with innovative new approaches and solutions.
However, for this positive momentum to continue, Canada must maintain a focus on cancer. Policymakers and health system leaders need to keep cancer as a priority when allocating healthcare resources, even when dealing with other pressing healthcare issues.
How the Partnership is putting a focus on cancer
Over the past three years, the Partnership has been working to build a shared way forward for cancer care through the pandemic. We continue to support our partners through tools, reports, funding and collaboration. This includes an investment of $13 million for partners to develop and pilot new models of delivering care across Canada over the next five years.
The new models of care are intended to ease pressures on healthcare workers, support all provinces and territories as Canada shifts from pandemic response to pandemic recovery, and drive equitable access to cancer care across the country. In 2022, we produced a models of care toolkit containing ideas and information that will support health system leaders in developing these projects. You can find it here:
We also produced The Road to Recovery: Cancer in the COVID-19 Era, a report that highlights innovative work underway and identifies improvements to boost cancer system capacity and save lives. It is available here:
Provinces and territories delivered innovative cancer care solutions throughout the pandemic
Provinces and territories have displayed impressive resilience in their response to the pandemic; however, more is needed to support the cancer system. The Road to Recovery report provides evidence, innovative solutions and resources that can help government decision-makers to maintain a focus on cancer when making investment decisions among the many competing pressures through the current and post-pandemic era.
Examples of innovative work underway include:
Virtual care being made routine:
- All jurisdictions shifted quickly to virtual care during the first months of the pandemic. Cancer Care Alberta is developing a large-scale virtual strategy to make it a routine part of care for appropriate cancer patients within the organization.
Family doctors providing chemotherapy:
- British Columbia (among other jurisdictions) has developed a General Practitioner in Oncology (GPO) program to strengthen the oncology skills of family doctors so they can enhance cancer care in their communities. These GPOs can support diagnosis, deliver chemotherapy and manage follow-up care, reducing the reliance on medical oncologists.
Reducing wait times:
- Clinical prioritization guidelines: Quebec has developed guidance to help clinicians and decision-makers prioritize patients balancing resource availability and clinical criteria.
- Centralized wait lists: Ontario has invested in the wide-scale adoption of electronic central wait list systems, which will help with hospital, regional and provincial planning of surgical access and load leveling.
Supports in First Nations, Inuit and Métis communities:
- Travel assistance: The Métis Nation–Saskatchewan Medical Travel Assistance Pilot Program improves outcomes for Métis people with cancer by reducing travel-related barriers that contribute to health inequities.
- Culturally appropriate colorectal cancer screening: 2020 saw the start of the first-ever organized colorectal cancer screening program in the Beaufort Delta region, an area that historically has had the lowest colorectal cancer screening rates in the Northwest Territories. The Beaufort Delta is home primarily to the Inuvialuit and Gwich’in First Nations in eight communities. Through close collaboration with Indigenous governments, local healthcare providers and community health representatives, the Northwest Territories Health and Social Services Authority developed a virtual engagement approach and community awareness campaign to ensure a culturally appropriate, respectful and community-centred approach to cancer screening.
Supports in rural and remote communities:
- Community oncology: In Nova Scotia, a community oncology program is augmenting services to support more equitable access to timely cancer diagnoses and support cancer survivors closer to home.
- Cancer care in Nunavut: In 2022, Nunavut opened its first specialty cancer clinic at the Qikiqtani General Hospital in Iqaluit, in collaboration with the Ottawa Hospital. This clinic allows people with a new diagnosis of cancer and those being followed after treatment to receive care closer to home.
Improved collection and use of data:
- Data is the key to advancing Canada’s cancer control efforts. The pandemic has hit underserved communities the hardest, but disaggregated data on the specific impacts on their health and well-being, including cancer prevention and care, is scarce. There is an urgent need to collect data on factors that affect health and healthcare, including race-based and socioeconomic data, which can inform pandemic response and recovery efforts centred around health equity – to ensure help is provided to those who need it the most.
The Partnership and Statistics Canada have developed a new tool for linking data between the Canadian Cancer Registry and the long-form census. This will allow for the effect of race, ethnicity and socio-economic characteristics to be reported on for cancer patients.
Where Canada needs to improve cancer care systems
Despite all this great work, Canada needs to allocate more healthcare resources to cancer care in the wake of the pandemic – and it needs to happen now, because with cancer, time is of the essence.
In particular, we need to focus on cancer in three key areas:
- Healthcare human resources: Canada’s cancer care professionals continue to do their utmost to provide excellent care through wave after wave of the COVID-19 pandemic, despite overwhelming pressures. However, the disruptions are taking their toll. Attrition and burnout are on the rise. More job vacancies are going unfilled. The burden on healthcare workers is heavy, and it is contributing to delays in cancer screening, diagnosis and treatment. The implications will be felt for years to come.
- Preparing for a surge in cases: Disruptions in prevention, early diagnosis and treatment services that occurred throughout the pandemic are expected to lead to a surge in cases diagnosed at later stages as well as increased care needs in the months and years to come. The system needs more capacity to respond optimally. This means ensuring resources are put in place so healthcare professionals can prioritize cancer surgeries and procedures.
- Leveraging the potential of new ways of delivering care, including those supported by digital technologies: New models of care, supported by digital tools, can help address system capacity and access constraints, but they require investments and changes to care policies and processes. The innovations in virtual and digital health and navigation that arose during the pandemic will be key to implementing new models of care.
Two out of every five people in Canada will be diagnosed with cancer in their lifetime. This is why we need to sustain the focus on cancer as health systems adapt to the realities of the post-pandemic era. As steward of the the 2019-2029 Canadian Strategy for Cancer Control (the Strategy), the Partnership will continue to support partners to drive the types of innovations that have contributed to increased cancer survival, supported pandemic recovery and delivered results across 13 provincial and territorial health systems.
Together, we can close the care gap and save lives.
Learn more at www.partnershipagainstcancer.ca.
About the Canadian Partnership Against Cancer
As the steward of the Canadian Strategy for Cancer Control, the Partnership works with Canada’s cancer community to take action to ensure fewer people get cancer, more people survive cancer, and those living with the disease have a better quality of life and all people in Canada have equitable access to quality cancer care. The Partnership is funded by Health Canada.
This article was produced through a financial contribution from Health Canada through the Canadian Partnership Against Cancer. The views expressed represent those of the Partnership.