Third annual web report evaluate Ontario’s cancer system

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Results of the 2007 Cancer System Quality Index – an online report that tells us how Ontario’s cancer system is performing – shows that cancer treatment wait times and quality are improving, but screening rates have stalled and more needs to be done to support people dying of cancer.

Launched in 2005 and updated annually, the Index is a publicly available web site that uses 30 measures to assess cancer system performance across the full spectrum of cancer care. A first of its kind in North America, the Index is used to improve cancer services and give health care providers and the public insight into cancer care.

“We are making significant gains in key areas of the cancer journey, and we are clearly falling short in others,” said Michael Decter, Chair, Cancer Quality Council of Ontario. “Health care professionals and organizations are using the Index to improve cancer prevention and care for patients. It is making all of us better informed about cancer.”

The Cancer System Quality Index highlights areas of progress including:

* Smoking rates continue to go down as a result of Ontario’s comprehensive Smoke-Free Ontario strategy, but Ontarians remain at significant risk in areas that are important targets for cancer prevention. Ontarians are facing growing rates of obesity, not eating enough fruits and vegetables and many more need to become physically active.

  • Screening programs have helped reduce deaths from breast and cervical cancer. While colorectal cancer screening rates remain very low, with just under 20% of people aged 50-74 receiving a regular Fecal Occult Blood Test (FOBT), Ontario’s new Colorectal Cancer Screening Program has the potential to dramatically boost screening rates.
  • Wait times for radiation therapy and cancer surgery are continually improving as a result of better planning, innovation and strategic investments in treatments, health professionals, and capital (buildings and equipment).
  • The increased use of clinical guidelines and standards by health professionals and cancer organizations is raising the quality of cancer care across the province.
  • The number of people diagnosed with cancer in Ontario is expected to grow by about 3% each year. However, survival is improving for patients with the three of the four most common cancers – prostate, breast and colorectal – as a result of better prevention, detection, and treatment. We are not seeing significant gains in lung cancer survival. “The Cancer System Quality Index tells us we need to take more action on cancer prevention, early detection and caring for patients after they complete their treatment,” said Terry Sullivan, PhD, President and CEO, Cancer Care Ontario. “Ontario’s Colorectal Cancer Screening Program will save lives. It’s crucial to ensure all our provincial screening programs reach vulnerable populations including people living in poverty, new Canadians and Aboriginals.”

    The Index points to areas that need greater attention including:

  • Incidence and death from cervical cancer in Ontario have decreased by more than 60% in the last 30 years largely as a result of screening with the Pap test. From 1989 to 2002, breast cancer mortality rates for women aged 50 to 69 decreased by 29% due to a combination of better treatments and increased participation in breast screening. However, cervical and breast screening rates have stalled in recent years at approximately 80% and 60% respectively, well below provincial targets. More effective approaches are needed to seek out and support vulnerable women with screening.
  • Chemotherapy treatment wait times have remained largely unchanged over the last three years. At the same time, Ontario has insufficient resources and infrastructure to meet the needs of the growing number of patients who will require chemotherapy.
“By using the same approach we’re using to reduce cancer surgery and radiation wait times, we will avoid a critical situation with chemotherapy,” said Sullivan. “Cancer Care Ontario is developing a plan to improve the coordination and distribution of high quality chemotherapy across communities and LHINs. A critical part of this is resolving Ontario’s shortage of medical oncologists and other oncology professionals.”

  • Approximately 85% of palliative patients have cancer. In 2003, 53% of cancer patients died in hospitals, while most cancer patients prefer to die at home or in a community setting. The Ministry and Long-Term Care is leading a provincial End of Life strategy to build palliative care capacity in community settings including home care and hospices. Alongside this provincial strategy, Cancer Care Ontario launched the Provincial Palliative Care Integration Project to improve symptom management for palliative cancer patients and ensure more patients are able to die in the place of their choice.
The Index is developed by the Cancer Quality Council of Ontario and Cancer Care Ontario in collaboration with the Institute for Clinical Evaluative Sciences and the University of Toronto, with input from more than 60 cancer experts.

The Cancer Quality Council of Ontario monitors and reports to the public on the quality and performance of the cancer system.

Cancer Care Ontario is the provincial agency that steers and coordinates Ontario’s cancer services and prevention efforts so that fewer people get cancer and patients receive the highest quality of care.

The Cancer System Quality Index can be accessed via the Cancer Care Ontario website at: www.cancercare.on.ca/qualityindex2007/