Robert Lawrie is a board chair of the Canadian Cancer Society (CCS). Philippe Couillard is a medical doctor and the former premier of Quebec. Bob Bell is the former deputy minister of health in Ontario. All three are on the board of directors at CCS.
Today is World Cancer Day – a day to raise attention and inspire action for a cancer-free future. But this World Cancer Day is different from any other. Globally, our efforts are united by a pandemic that has taken the lives of nearly two million people and upended every aspect of our daily lives. This February 4 is dramatically different than one year ago.
First, the good news: Over the past 30 years, Canada’s cancer mortality rates have been declining, falling around 35 per cent in males and 20 per cent in females, reflecting progress made in early detection and treatment.
However, because of disruptions from COVID-19 in Canada’s health care system, some of these improvements are at risk of being lost. According to the Canadian Institute for Health Information, between March and June of 2020, there was a 20-per-cent reduction in cancer surgeries compared with the same period in 2019. In a survey of people with cancer and caregivers conducted by the Canadian Cancer Society in July, 2020, 47 per cent of patients reported having their cancer care appointments postponed or disrupted because of the pandemic.
Postponing cancer treatment can be the difference between life and death. A Canadian-led study published in the British Medical Journal shows that just a four-week delay in cancer treatment increases the risk of death by about 10 per cent. With alarming data like this, it is no wonder people living with cancer and their caregivers are feeling increased anxiety.
These continuing delays are not only affecting cancer treatment. Care has been delayed and interrupted across many parts of our health care system, affecting people facing other serious illnesses and diseases.
Before our hospitals can shrink these backlogs and address the needs of people with cancer and other critical illnesses, the first priority rightly is to bring this virus under control.
As Canadians, we can protect the lives of people with cancer by following public-health regulations to end this pandemic quickly – wear masks, practice physical distancing and get vaccinated when the vaccine is available.
At the same time, the lessons learned from COVID-19 present an opportunity to build back better – not just for cancer care but for all the health care for Canadians. In doing so, innovative solutions are required. These are powerful and transformative examples of systems change required to modernize, improve efficiencies and prioritize patient needs.
The first change is to implement modern digital referral systems to health care. E-commerce allows us to track the delivery times of our purchases. Compare that level of customer service to the anxious Canadian who is told an intervention is urgently needed to rule out cancer or a heart issue. The referral for that intervention will have been faxed from GP to specialist, but the patient has no way to track progress toward the appointment. Surely, tracking these appointments is more important than tracking delivery of boxes. Commercial systems are already available to send referrals directly from family doctors to specialists, but governments are implementing them at a snail’s pace. With instantaneous referrals and tracking capabilities, these systems would reduce patient anxiety and help them feel more informed.
Next, we need to centralize referral lists for various procedures, so the highest priority tests and surgeries are undertaken by the first available specialist with the appropriate qualifications. Too many patients are on one surgeon’s long waiting list while another surgeon has a shorter list.
Finally, COVID-19 also shows us that, when overnight stays and monitoring aren’t required, we should move surgeries and procedures out of hospitals to dedicated ambulatory centres that are purpose-built to provide care more efficiently. These centres provide equivalent quality care less expensively and allow in-patient hospital beds to be reserved for pandemic patients and other more complex interventions.
A substantial investment is necessary to clear the enormous backlog in our Canadian health care system. However, simply investing enough to get us back to the former standard, without making our overall health care system more efficient and customer friendly, would be a missed opportunity. On this World Cancer Day, we call on our governments and health care leaders to be forward-thinking so that we can have a more efficient health care system for all Canadians. We must invest more now to build it back better.
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