Cancer care in Canada

Two in every five Canadians are expected to develop some type of cancer during their lifetime, with one in four expected to die from their disease.1

The economic burden of cancer care on all payers in Canada is substantial. The cost of cancer care in Canada has risen steadily from $2.9 billion in 2005 to $7.5 billion in 2012, mostly owing to the increase in costs of hospital-based care.2 With the growing burden of cancer, and the resultant financial pressures on our healthcare systems, there is an urgent need to improve efficiencies and reduce waste in cancer care in Canada. Improving efficiency is not a question of linear cost-cutting, but of finding ways to allocate resources more efficiently to achieve better health outcomes for patients.

Although some areas of healthcare in Canada are publicly funded in whole or in part, cancer patients – particularly those in rural areas and/or with limited access to financial resources – often experience high out-of-pocket health costs due to travel, missed work, and uninsured or underinsured drug expenditures. Alternatively, they forgo necessary treatments because they cannot afford them, with dire health consequences.

All.Can Canada initiative

In April 2018, Save Your Skin Foundation (SYSF), a national patient-led not-for-profit group dedicated to leading the fight against non-melanoma skin cancers, melanoma and ocular melanoma, was established as All.Can Canada’s Secretariat to lead the initiative in Canada. SYSF convened a Working Group to discuss how to bring All.Can into the Canadian healthcare space. The Working Group completed a year one discovery phase that involved an informal literature review of nation-wide and province-specific health care reports to identify the top reported areas of waste and inefficiency in cancer care in Canada. These findings were then prioritized through anonymous surveys with cancer care stakeholder groups, including patient group representatives, health care professionals, provincial policy makers, health technology assessment bodies, and pharmaceutical industry representatives. This information was also reviewed in light of responses from over 300 Canadian cancer patients who took part in the All.Can International Patient Survey.

This information was used to produce a Consolidated Report of Waste and Inefficiency in Canadian Cancer Care: Multi-Stakeholder Insights and Recommendations. This report highlights the common themes across stakeholder groups of areas of greatest waste and inefficiency in Canadian cancer care systems.

All.Can Canada, through SYSF and its working group, organized a first multi-stakeholder roundtable in late 2019 to develop consensus on a focus area to begin its work. The consensus statement developed for All.Can Canada is to focus on optimizing patient entry into Canadian cancer care systems, ensuring swift, accurate and appropriately delivered diagnosis and that patients experience coordinated, effective support throughout their treatment experience. The preliminary focus will be on ensuring swift, accurate and appropriately delivered diagnosis as the entry point into the cancer care system.

To direct All.Can Canada’s activities, a multi-stakeholder, patient-led Interim Steering Committee was established to direct an environmental scan to evaluate the capacity of the current cancer care systems in Canada to achieve the consensus statement and provide the basis of the future objectives and action plan for All.Can Canada; to organize a second, multi-stakeholder roundtable to assess the results of the environmental scan; and to determine the objectives and action plan. The final report from this research, Optimizing Diagnosis in Canadian Cancer Care has been published and was used to direct conversations at the second roundtable meeting in November 2021.

Why Focus on Diagnosis?

Earlier diagnosis means better health outcomes and reduced healthcare costs. Delays are correlated with increased mortality. The cost of cancer care in Canada has risen from $2.9 billion in 2005 to $7.5 billion in 2021, largely due to the increased costs in hospital-based care. In Canada, in 2022, sixty-three percent of new cancers were diagnosed through the investigation of symptoms as compared to thirty-seven percent diagnosed by screening. There are also many cancers for which there are no screening programs. As a result, it is crucial to attend to how to improve earlier cancer diagnoses through symptom presentation in order to save lives and reduce health system costs.

 

Activities and milestones

2019:

  • Gathered real world data and patient-reported areas of inefficiency and waste through a national patient survey with 300+ respondents and a scan of literature on nation-wide and province specific health care reports
  • Validated and prioritized data through consultation with pharmaceutical industry partners, patient representative groups, health care professionals, health technology assessment bodies and policy makers
  • Hosted an inaugural roundtable meeting of all key oncology stakeholder sectors to find consensus on the top areas of inefficiency and waste in Canadian cancer care and identify the area of focus for All.Can Canada in 2020 and beyond

2020:

  • Distributed Roundtable Report and final Consolidated report on waste and inefficiency in Canadian cancer care with consensus statement to attendees and stakeholders
  • Assembled All.Can Canada interim steering committee with representation from all stakeholder groups to support, guide and oversee the progress of a multi-year research project that was derived from the roundtable
  • Conducted a rigorous environmental scan, including literature review, patient interviews, and provider survey, to assess the current state of cancer diagnosis within Canadian cancer care systems, gather nominated practices, provide insights for a preliminary quality framework, and offer recommendations for change
  • Launched COVID-19 Cancer Patient Support Hub, bringing together Canadian oncology patient groups, mental health expertise and health care providers to respond to immediate, emotional and practical needs of Canadian oncology patients during the COVID-19 pandemic
  • Hosted a 2nd roundtable meeting of all key oncology stakeholder sectors to review ‘Optimizing Diagnosis in Canadian Cancer Care’ Report to identify opportunities to advance the recommendations of the report and begin to move towards an improved future state in cancer diagnosis using the results of All.Can Canada’s research

2021:

  • Continued research to assess the current state of cancer diagnosis within Canadian cancer care systems, gather nominated practices, provide insights for a preliminary quality framework
  • Presented research findings and recommendations at the North American Integrated Care Conference
  • Hosted 2nd roundtable meeting of all key oncology stakeholder sectors to review the findings from All.Can Canada’s ‘Optimizing Diagnosis in Canadian Cancer Care‘ research report and gain insights from key stakeholders on opportunities to advance the recommendations in the report and move towards an improved future state in cancer diagnosis

2022:

  • Distributed 2nd Roundtable Report to attendees and stakeholders
  • Published Optimizing Diagnosis in Canadian Cancer Care (French version: Optimizer le diagnostic du cancer au Canada)
  • Created a 3-year Strategic Plan (2022-2024) with a Vision, Mission, Values, 5 Strategic Priorities, and 2 Enablers, plus a 1-year Operational Plan to guide the work of All.Can Canada
  • Created a new organizational structure to work towards long-term policy and professional behaviour outcomes with an updated patient-led, multi-stakeholder Steering Committee and three working groups to support the work of the network:
    • Evidence
    • Stakeholder Engagement
    • Knowledge Mobilization
  • Met with policymakers from the province of Alberta to share research findings and recommendations to improve cancer diagnosis
  • Presented research findings and recommendations at the Canadian Centre for Applied Research in Cancer Control, the Canadian Association of Nursing in Oncology Conference, and the Canadian Association of Psychosocial Oncology Conference
  • Developed a methodology to assess best practices and search for new best practices, including those related to seamless care and navigation

2023:

2024: 

  • Published 2023 Annual Report
  • Hosted the Optimizing Equitable Diagnoses in Canada Roundtable, which brought together providers and advocates working healthcare for racialized, LGBTQIA+, neurodivergent, and other structurally underserved groups and for First Nations, Inuit, and Métis peoples (January 17-19, 2024) (report to follow)
  • Presented at the Quebec Cancer Coalition Symposium : Dépistage du Cancer Conference (February 2024)

References

  1. Canadian Cancer Society Available here: http://www.cancer.ca/en/cancer-information/cancer-101/cancer-statistics-at-a-glance/?region=bc#ixzz5RZs2GjPG [accessed: September 2018]
  2. Claire de Oliveira, MA, PhD*, Sharada Weir, MA, DPhil et al. The economic burden of cancer care in Canada: a population-based cost study. CMAJ Available here: http://cmajopen.ca/content/6/1/E1.full [accessed: September 2018]
  3. Elison L, Saint-Jacques N. Five-year cancer survival by stage at diagnosis in Canada. Statistics Canada. January 18, 2023.
  4. Sarma E et al. Achieving Diagnostic Excellence for Cancer: Symptom Detection as a Partner to Screening. JAMA. July 18, 2022
  5. Hanna T P, King W D, Thibodeau S, Jalink M, Paulin G A, Harvey-Jones E et al. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ 2020;371:m4087
  6. Oliveira, D., Weir, S., Rangrek, J., Krahn, M., Mittman, N., Hoch, J., Chan, K., Peacock, S. The economic burden of cancer care in Canada: a population-based cost study. CMAJ 2018, 6(1), E1-E10.
  7. Canadian Cancer Society, "Statistics at a Glance" Available here: https://cancer.ca/en/research/cancer-statistics/cancer-statistics-at-a-glance

Event: Optimizing Equitable Cancer Diagnoses in Canada Roundtable

In Toronto, Ontario in either December 2023 or January 2024, All.Can Canada will host the Optimizing Equitable Cancer Diagnoses in Canada Roundtable. This event…

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Contact

Secretariat: Save Your Skin Foundation

all.can@saveyourskin.ca

Steering Committee and Working Group members

Kathy Barnard

Save Your Skin Foundation

Louise Binder

Save Your Skin Foundation

Martin Dawes, MB.BS, MD, DRCOG, FRCGP

Department of Family Practice, University of British Columbia

Martine Elias

Myeloma Canada

Amy Hayes

Lung Ambition, AstraZeneca

Lorraine Hudson

AstraZeneca

Rachael Manion

Canadian Association of Psoriasis Patients

Tim Marshall

Roche

Christine Meisner

Amgen Canada

Stephanie Michaud

BioCanRX

Josée Pelletier

Bristol Myers Squibb Canada

Dr. Jennifer Rayner

Alliance for Healthier Communities Ontario

Ambreen Sayani

Women's College Hospital, Toronto, Ontario

Antonella Scali

Canadian Psoriasis Network

Filomena Servidio-Italiano

Colorectal Cancer Resource & Action Network

Cheryl Simoneau

The Chronic Myelogenous Leukemia (CML) Society of Canada

Christina Sit

The Leukemia & Lymphoma Society of Canada

Dr. Michael Smylie

Cross Cancer Institute, Alberta Health Services

Natalie Verreault

Roche

Brigitte Viel

Pfizer

Eva Villalba

Coalition Priorité Cancer au Québec

Caroline Wong

Center for Excellence on Patient and Public Partnership

Janice Wright, MD, CCFP

InspireHealth Supportive Cancer Care

Stephanie Condon-Oldreive

Craig's Cause

Erin Ranger

Craig's Cause

Monika Slovenic D’Angelo

University of Ottawa

Paula Holmes-Rodman

Independent Researcher

Rashi Khare

Integrated University Health and Social Services Centre West-Central Montreal

Sara Rauhullah

AstraZeneca

Marie-Helene Perreault

AstraZeneca Canada

Secretariat

Aurelia Roman

Amy Rosvold

Save Your Skin Foundation

Leah Stephenson

Leah M Stephenson Consulting

Taylor Tomko

Event: Optimizing Equitable Cancer Diagnoses in Canada Roundtable

In Toronto, Ontario in either December 2023 or January 2024, All.Can Canada will host the Optimizing Equitable Cancer Diagnoses in Canada Roundtable. This event will consist of two days of dialogue followed…

New All.Can Canada Case Studies

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‘Optimizing Diagnosis in Canadian Cancer Care’

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Improving Diagnosis in Canadian Cancer Care

By Amy RosvoldSave Your Skin Foundation How the research began In November 2019, All.Can Canada hosted an inaugural multi-stakeholder roundtable meeting to share findings on top areas of inefficiency in…

All.Can Canada COVID-19 Cancer Patient Support Hub

All.Can Canada brought together leading Canadian not-for-profit patient groups to create the COVID-19 Cancer Patient Support Hub in early May 2020.The aim of the Support Hub is to provide Canadians…

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All.Can member Amy Jones writes about the psychological impact of cancer and the need for improved for psychological support.

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Case Studies

Publications & Reports

Knowledge Products

Patient Information Framework | cadre d’information pour les patients Nov 2023

Patient Information Framework | cadre d’information pour les patients Larger format for visual impairments

“When We Hear Cancer” Patient Needs During Diagnosis Infographic | Infographie Lorsque les patients entendent le mot <<cancer>>: Besoins psychosociaux pendant le diagnostic Nov 2023

Disclaimer:

The All.Can initiative is made up of leading representatives of patient organisations, policymakers, healthcare professionals, science and industry. All the publications produced under the initiative reflect the consensus of All.Can members who have full editorial control.

The All.Can initiative in Canada is made possible with financial support from Bristol Myers Squibb Canada (main sponsor), Merck Canada, Roche, Johnson & Johnson, AstraZeneca, Amgen, Novartis and Sanofi.

None of the content developed in discussions and activities of the All.Can initiative contains direct or indirect references to specific medicinal products or therapies. Use of content from this website is permitted provided that the source of information is clearly mentioned.