Report Card 2000 on Cancer Care in Canada

Click here to view page 1 & 2 of the Report Card: Part 1: The State of Cancer Care Today, and Cancer in Canada Then & Now

Click here to view page 3 & 4 of the Report Card: Part 2: Provincial Round-Up: What We Know About Cancer in the Provinces

Click here to view page 5 & 6 of the Report Card: Provincial Round-Up: What We Know About Cancer in the Provinces and comments by Michael Decter (continued) and Part 3: Problems Attracting and Retaining Cancer Care Professionals

Click here to view page 7 & 8 of the Report Card: Part 3: Problems Attracting and Retaining Cancer Care Professionals (continued)

Click here to view page 9 of the Report Card Part 3: Problems Attracting and Retaining Cancer Care Professionals (continued)

Click here for the full interview with noted oncologist Bill Hryniuk, the former director of the Hamilton Regional Cancer, who now practices in Detroit.





Report Card 2000 Summary

In an ideal world, cancer advocates would be able to assess the performance of different facets of the cancer care system and clearly identify gaps in care that need to be addressed. We would be able to see which provinces were getting the best (and worst) results and direct our efforts to raising performance to an acceptable standard across the board. We don't live in that world. As Michael Decter says, 'Accountability for and comparisons of health system performance will only be possible once every province is collecting the same data and using the same definitions.' Right now they're not. And that makes information itself the accuracy of information, transparency of information, and comparability of information an issue that advocates must address. We are assured that efforts are underway to improve information gathering and dissemination, through CIHI and Statistics Canada. Let's make sure that happens.

WHAT WE DO KNOW
Despite the 30-year-old war on cancer, improvements in our ability to treat cancer effectively once a person is diagnosed remain localized and small. Using National Cancer Institute data to trace the incidence and mortality from the four leading cancer killers over 30 years, we see no improvement in treating lung cancer, a small gain in survival from colorectal cancer and, in breast and prostate cancers, small survival improvements in the face of soaring incidence. Few provinces can state how many of their residents are currently living with a cancer diagnosis, a number which would do much to accurately assess resource needs in the population. Survival rates for various cancers do appear to differ somewhat between provinces, but until the definitions and data collection and analysis methods are standardized, no firm conclusions can be drawn.

We know anecdotally that people are waiting too long for cancer treatments, especially radiation therapy, but provinces are only beginning (and unevenly at that) to track waiting times. We do know that the standard of care set by the Canadian Association of Radiation Oncologists a four week maximum wait between referral to a radiation oncologist and first treatment) is met for only 40% of Ontario patients and between 32% and 62% of British Columbia patients.

Canada faces a serious and growing shortage of cancer care professionals that poses a significant threat to the quality of care patients receive. 'We are seeing regular, repetitive and serious deficiencies in the cancer workforce,' according to Dr. Andrew Padmos, head of the QEII Health Sciences Centre Cancer Program in Nova Scotia. Cancer care professionals themselves report that patient care is suffering as a result of shortages. Provincial cancer agencies have, to date, engaged in aggressive recruiting from other provinces as well as internationally, which only intensifies problems in some parts of the country. Representatives of every professional group, from radiation therapists to radiation and medical oncologists, radiologists and oncology nurses, point to a need for a national human resources strategy that takes a long-term view and a multi-departmental approach. Education and Immigration policies must be made to serve the overall cause of assuring a stable and sufficient supply of professionals. Cooperation, between provinces, between professional associations, and between ministries, is needed.