By Dr. Christian Finley

Surgery is often the best treatment for cancer, but access to it varies across Canada – and correspondingly so do cancer survival rates. These disparities are why the Canadian Partnership Against Cancer brought together 11 surgical associations to develop the Pan-Canadian Action Plan for cancer surgery. The goal of the group – known collectively as the Canadian Network of Surgical Associations for Cancer Care (CANSACC) – is to ensure quality surgical oncology care is available to everyone, regardless of geography or income.

The COVID-19 pandemic has put great strain on the healthcare system. This is why, more than ever, we need healthcare providers and organizations working together to break down barriers and ensure equitable access to high-calibre surgical care. Across the healthcare system, we all have a role to play. The Pan-Canadian Action Plan for cancer surgery points the way.

About the Pan-Canadian Action Plan for cancer surgery

The plan has its roots in the Partnership’s 2015 report, Approaches to high-risk, resource intensive cancer surgical care, which found tremendous variances across Canada in resection rates, in-hospital mortality and length of stay for high-risk cancer surgical patients. It also stems from the 2019-2029 Canadian Strategy for Cancer Control, a 10-year roadmap to improve outcomes and equity in the Canadian cancer system. The action plan outlines the actions Canada’s health system stakeholders must take to reduce wait times, improve rates of curative surgery, and provide the best possible outcomes for patients post-operatively.

The plan’s key priorities include:

• Deliver high-quality surgical oncology care;
• Eliminate barriers to surgical cancer care for vulnerable and underserviced populations;
• Establish pan-Canadian benchmarking and data-driven quality improvement to cancer surgeries;
• Integrate surgical care and medical services to improve outcomes; and
• Support research and innovation in surgical cancer care.

Important next steps

There is much to be done. One of the most urgent priorities is the need to provide respectful, responsive, timely, and culturally appropriate surgical care to underserviced and vulnerable populations.

In part, this will require funding and support for approaches to speed up the diagnostic phase. The sooner a patient is diagnosed and treated, the greater their chances of survival and the lower their stress. Early diagnosis is also an important part of the Canadian Strategy for Cancer Control, and initiatives are already underway in many provinces that have decreased wait times and improved access to care. We must ensure this level of rapid diagnosis is available everywhere.

Also crucial is making better data available to stakeholders in all regions of the country. Pan-Canadian, integrated, systematic benchmarking would allow for data-driven quality improvement across cancer surgeries. The action plan offers guidance on steps to build such a system over the long term. In the meantime, we need to make use of all the data we do have. Institutions should be able to access timely data to compare their performance and outcomes with their peers and cultivate a culture of continuous learning. This can help to inspire improvement, which in turn will help all patients to thrive.

Integration of surgical cancer care and medical services is vital, too. For instance, home care should be coordinated with surgeons and hospitals to provide 24-hour on-call services to help reduce emergency and hospital re-admissions. In addition, given the central role primary care physicians play in managing comorbid conditions and treating psycho-social symptoms, which are common among cancer patients, we need to do a better job of collaboration between surgical, cancer and primary care.

The entire healthcare system is under tremendous pressure due to the COVID-19 pandemic. However, we must continue to work together to improve access to cancer surgery.  The Pan-Canadian Action Plan for cancer surgery will help us to do that, collaborating, removing barriers, and sharing data and best practices to ensure more equitable access to potentially life-saving surgical cancer care for all.

To find out more about the Pan-Canadian Action Plan for cancer surgery and the role you can play, please visit our website: Action plan to optimize cancer surgery in Canada – Canadian Partnership Against Cancer.

Dr. Christian Finley is a thoracic surgeon at St. Joseph’s Health Centre in Hamilton, Ontario and Expert Lead, Clinical Measures, at the Canadian Partnership Against Cancer.