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2009 Quality Index Reports on Ontario’s Cancer System


Increasing Burden of Cancer Beginning to Strain Parts of the System

Despite improvements to the cancer system including lower smoking rates and better screening and care for colorectal cancer patients, this year’s Cancer System Quality Index also reports that the increasing burden of cancer is beginning to strain parts of the cancer system. 

“The overall quality of the cancer system is very good with many indicators showing improvements each year,” said Michael Decter, Chair, Cancer Quality Council of Ontario.  “At the same time, there is still room for improvement.  We continue to see higher obesity rates and a significant number of the population not following low-risk drinking guidelines that we know raise a person’s risk of cancer.  As a society we are still not doing enough and require greater commitment on the part of Ontarians, governments, and health professionals to promote healthier lifestyles and modify behaviours.” 

More than half of all cancers are preventable and about half of cancer deaths are related to tobacco use, diet and physical activity.  However, while Ontarians are more physically active (48 per cent) and consuming more fruits and vegetables (42 per cent) than in 2001, at 17 per cent of the population, the obesity rate continues to be a concern.

The Index shows gains being made in the fight against colorectal cancer, the second leading cause of cancer deaths in Ontario. Significant progress has been made towards improving screening, diagnosis and treatment for colorectal cancer patients, which are all contributing to better survival rates.    In the past year, screening for colorectal cancer increased by 30 percent and diagnostic colonoscopies are being completed in a timely manner.  Survival for colorectal cancer has increased to 62 per cent -- up 11 per cent from the previous decade.

“I am pleased to see the progress Ontario is making in screening for colorectal screening.  The Ontario Government’s commitment to the ColonCancerCheck program is making a difference. If detected early enough, there is a 90 per cent chance of surviving colorectal cancer, so that’s why screening and early detection are so critical.  We have a ways to go but we are on the right track,” said Terrence Sullivan, President and CEO, Cancer Care Ontario.

The increasing burden of cancer is largely attributed to an ageing population and it is beginning to impact the capacity of the system.  An area where the cancer system is starting to show signs of strain is chemotherapy.  Until now, Ontario has been able to keep wait times for chemotherapy in check.  However, the Index shows that wait times for chemotherapy are starting to increase.

“Cancer Care Ontario is looking at ways to maximize resources to ensure that patients receive timely access to chemotherapy as close to home as possible,” noted Sullivan.  “We are working with the regions and the Ministry of Health and Long-Term Care to address this issue.”

Other highlights from the Cancer System Quality Index include:

  • Despite most patient wishes, over half of Ontario cancer deaths occurred in an acute care hospital setting, but these numbers are beginning to decrease.  In addition, over 40 per cent of cancer patients are visiting the emergency department for pain and symptom control in the last two weeks of their life.
  • Wait times for cancer surgeries show some modest improvements, but variation exists across regions in their ability to meet targets for the higher priority surgeries (priority two and three cases).
  • With the exception of lung cancer survival, rates for the 4 most common cancers (prostate, breast, colon and lung) have significantly improved since 1991-1995.  Too many lung cancer patients (78 per cent) are diagnosed in the later stages of the disease (stages three or four). 
  • The vast majority (97 per cent) of cancer patients treated in outpatient units continue to report a reasonably high degree of satisfaction with most aspects of their care.   While scores for emotional support, remain lower (this indicator was rated as satisfactory by only 51 per cent of cancer patients).

The Cancer Quality Council of Ontario monitors and reports to the public on the quality and performance of the cancer system. The Cancer System Quality Index was launched in 2005 and presents a rolling snapshot of activity in 29 key indicators that cover the spectrum of cancer services, from prevention through to end-of-life care.

Cancer Care Ontario is the provincial agency responsible for continually improving cancer services. As the government’s cancer advisor, Cancer Care Ontario works to reduce the number of people diagnosed with cancer and make sure that patients receive better care every step of the way. 

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