Cancer care in Canada
Two in every five Canadians are expected to develop some type of cancer during their lifetime, with one in four expected to die from their disease.1
The economic burden of cancer care on all payers in Canada is substantial. The cost of cancer care in Canada has risen steadily from $2.9 billion in 2005 to $7.5 billion in 2012, mostly owing to the increase in costs of hospital-based care.2 With the growing burden of cancer, and the resultant financial pressures on our healthcare systems, there is an urgent need to improve efficiencies and reduce waste in cancer care in Canada. Improving efficiency is not a question of linear cost-cutting, but of finding ways to allocate resources more efficiently to achieve better health outcomes for patients.
Although some areas of healthcare in Canada are publicly funded in whole or in part, cancer patients – particularly those in rural areas and/or with limited access to financial resources – often experience high out-of-pocket health costs due to travel, missed work, and uninsured or underinsured drug expenditures. Alternatively, they forgo necessary treatments because they cannot afford them, with dire health consequences.
All.Can Canada initiative
In April 2018, Save Your Skin Foundation (SYSF), a national patient-led not-for-profit group dedicated to leading the fight against non-melanoma skin cancers, melanoma and ocular melanoma, was established as All.Can Canada’s Secretariat to lead the initiative in Canada. SYSF convened a Working Group to discuss how to bring All.Can into the Canadian healthcare space. The Working Group completed a year one discovery phase that involved an informal literature review of nation-wide and province-specific health care reports to identify the top reported areas of waste and inefficiency in cancer care in Canada. These findings were then prioritized through anonymous surveys with cancer care stakeholder groups, including patient group representatives, health care professionals, provincial policy makers, health technology assessment bodies, and pharmaceutical industry representatives. This information was also reviewed in light of responses from over 300 Canadian cancer patients who took part in the All.Can International Patient Survey.
This information was used to produce a Consolidated Report of Waste and Inefficiency in Canadian Cancer Care: Multi-Stakeholder Insights and Recommendations. This report highlights the common themes across stakeholder groups of areas of greatest waste and inefficiency in Canadian cancer care systems.
All.Can Canada, through SYSF and its working group, organized a first multi-stakeholder roundtable in late 2019 to develop consensus on a focus area to begin its work. The consensus statement developed for All.Can Canada is to focus on optimizing patient entry into Canadian cancer care systems, ensuring swift, accurate and appropriately delivered diagnosis and that patients experience coordinated, effective support throughout their treatment experience. The preliminary focus will be on ensuring swift, accurate and appropriately delivered diagnosis as the entry point into the cancer care system.
To direct All.Can Canada’s activities, a multi-stakeholder, patient-led Interim Steering Committee was established to direct an environmental scan to evaluate the capacity of the current cancer care systems in Canada to achieve the consensus statement and provide the basis of the future objectives and action plan for All.Can Canada; to organize a second, multi-stakeholder roundtable to assess the results of the environmental scan; and to determine the objectives and action plan. The final report from this research, Optimizing Diagnosis in Canadian Cancer Care has been published and was used to direct conversations at the second roundtable meeting in November 2021.
Activities and milestones
- Gathered real world data and patient-reported areas of inefficiency and waste through a national patient survey with 300+ respondents and a scan of literature on nation-wide and province specific health care reports
- Validated and prioritized data through consultation with pharmaceutical industry partners, patient representative groups, health care professionals, health technology assessment bodies and policy makers
- Hosted an inaugural roundtable meeting of all key oncology stakeholder sectors to find consensus on the top areas of inefficiency and waste in Canadian cancer care and identify the area of focus for All.Can Canada in 2020 and beyond
- Distributed Roundtable Report and final Consolidated report on waste and inefficiency in Canadian cancer care with consensus statement to attendees and stakeholders
- Assembled All.Can Canada interim steering committee with representation from all stakeholder groups to support, guide and oversee the progress of a multi-year research project that was derived from the roundtable
- Conducted a rigorous environmental scan, including literature review, patient interviews, and provider survey, to assess the current state of cancer diagnosis within Canadian cancer care systems, gather nominated practices, provide insights for a preliminary quality framework, and offer recommendations for change
- Launched COVID-19 Cancer Patient Support Hub, bringing together Canadian oncology patient groups, mental health expertise and health care providers to respond to immediate, emotional and practical needs of Canadian oncology patients during the COVID-19 pandemic
- Hosted a 2nd roundtable meeting of all key oncology stakeholder sectors to review ‘Optimizing Diagnosis in Canadian Cancer Care’ Report to identify opportunities to advance the recommendations of the report and begin to move towards an improved future state in cancer diagnosis using the results of All.Can Canada’s research
- Continued research to assess the current state of cancer diagnosis within Canadian cancer care systems, gather nominated practices, provide insights for a preliminary quality framework
- Presented research findings and recommendations at the North American Integrated Care Conference
- Hosted 2nd roundtable meeting of all key oncology stakeholder sectors to review the findings from All.Can Canada’s ‘Optimizing Diagnosis in Canadian Cancer Care‘ research report and gain insights from key stakeholders on opportunities to advance the recommendations in the report and move towards an improved future state in cancer diagnosis
- Distributed 2nd Roundtable Report to attendees and stakeholders
- Published Optimizing Diagnosis in Canadian Cancer Care (French version: Optimizer le diagnostic du cancer au Canada)
- Created a 3-year Strategic Plan (2022-2024) with a Vision, Mission, Values, 5 Strategic Priorities, and 2 Enablers, plus a 1-year Operational Plan to guide the work of All.Can Canada
- Created a new organizational structure to work towards long-term policy and professional behaviour outcomes with an updated patient-led, multi-stakeholder Steering Committee and three working groups to support the work of the network:
- Stakeholder Engagement
- Knowledge Mobilization
- Met with policymakers from the province of Alberta to share research findings and recommendations to improve cancer diagnosis
- Presented research findings and recommendations at the Canadian Centre for Applied Research in Cancer Control, the Canadian Association of Nursing in Oncology Conference, and the Canadian Association of Psychosocial Oncology Conference
- Developed a methodology to assess best practices and search for new best practices, including those related to seamless care and navigation
- Met with policy makers from the provinces of Nova Scotia, British Columbia and Prince Edward Island to share research findings and recommendations to improve cancer diagnosis
- Canadian Cancer Society Available here: http://www.cancer.ca/en/cancer-information/cancer-101/cancer-statistics-at-a-glance/?region=bc#ixzz5RZs2GjPG [accessed: September 2018]
- Claire de Oliveira, MA, PhD*, Sharada Weir, MA, DPhil et al. The economic burden of cancer care in Canada: a population-based cost study. CMAJ Available here: http://cmajopen.ca/content/6/1/E1.full [accessed: September 2018]
Steering Committee and Working Group members
Save Your Skin Foundation
Save Your Skin Foundation
Martin Dawes, MB.BS, MD, DRCOG, FRCGP
Department of Family Practice, University of British Columbia
Lung Ambition, AstraZeneca
Canadian Skin Patient Alliance/Canadian Association of Psoriasis Patients
Bristol Myers Squibb Canada
Dr. Jennifer Rayner
Alliance for Healthier Communities Ontario
Women's College Hospital, Toronto, Ontario
Canadian Psoriasis Network
Colorectal Cancer Resource & Action Network
The Chronic Myelogenous Leukemia (CML) Society of Canada
The Leukemia & Lymphoma Society of Canada
Dr. Michael Smylie
Cross Cancer Institute, Alberta Health Services
Coalition Priorité Cancer au Québec
Health Policy Partnership, UK
Center for Excellence on Patient and Public Partnership
Janice Wright, MD, CCFP
InspireHealth Supportive Cancer Care
Monika Slovenic D’Angelo
University of Ottawa
Save Your Skin Foundation
Leah M Stephenson Consulting
Event: Optimizing Equitable Cancer Diagnoses in Canada Roundtable
New All.Can Canada Case Studies
‘Optimizing Diagnosis in Canadian Cancer Care’
All.Can Canada’s 2nd Multi-Stakeholder Virtual Roundtable Meeting
Improving Diagnosis in Canadian Cancer Care
All.Can Canada COVID-19 Cancer Patient Support Hub
All.Can Canada COVID-19 Cancer Patient Support Hub
The psychological impact of cancer: a Canadian perspective
All.Can member Amy Jones writes about the psychological impact of cancer and the need for improved for psychological support.
255 Canadian cancer patients share the most wasteful and inefficient parts of their cancer care and treatment
Canada joins international patient survey to improve cancer care
The All.Can patient survey has now launched in Canada.
- CASE STUDY #1: Diagnostic Assessment Programs (DAP) / Programmes D’Évaluation Diagnostique | August 2023
- CASE STUDY #2: Diagnostic Assessment Programs- Electronic Pathway Solutions (DAP-EPS) / Programmes D’Évaluation Diagnostique: Solution de passerelle électronique | August 2023
- CASE STUDY #3: Oncology Nurse Navigators (ONN) / Infirmières et Infirmiers pivots en Oncologie | August 2023
- CASE STUDY #6: BC Clinical Practice Guideline Evaluation | December 8, 2023
Publications & Reports
- CONFERENCE ABSTRACT: When We Hear “Cancer”: Patients’ Psychosocial Needs during Diagnosis, Abstract Proceedings of the 38th Annual Canadian Association of Psychosocial Oncology (CAPO) Conference | June 2023
- THREE-YEAR STRATEGIC PLAN (2022): All.Can Canada Three-Year Strategic Plan | French Translation
- ANNUAL REPORT: All.Can Canada 2022
- CONFERENCE ABSTRACT: Optimizing Entry into Canadian Cancer Care Systems, International Journal of Integrated Care | May 2022
- FULL REPORT: Optimizing Diagnosis in Canadian Cancer Care / Optimiser le diagnostic du cancer au Canada | Feb 2022
- SUMMARY: Optimizing Diagnosis in Canadian Cancer Care / Optimiser le diagnostic du cancer au Canada | Feb 2022
- PRESS RELEASE: New Report Reveals Opportunities to Improve Cancer Diagnosis – The Most Inefficient Area of Cancer Care in Canada / Un nouveau rapport propose des possibilités d’amélioration en matière de diagnostic du cancer — le domaine le plus inefficace des soins contre le cancer au Canada | Feb 2022
- All.Can Canada 2nd Roundtable Meeting Report Back | Dec 2021
- Consolidated Report of Waste and Inefficiency in Canadian Cancer Care: Multi-Stakeholder Insights and Recommendations | Feb 2020
- All.Can Canada November 2019 Inaugural Roundtable Meeting Report | Dec 2019
- Patient insights on Canadian cancer care: opportunities for improving efficiency: Canadian and province-specific findings from the international All.Can patient survey | Sept 2019
Patient Information Framework | Nov 2023
The All.Can initiative is made up of leading representatives of patient organisations, policymakers, healthcare professionals, science and industry. All the publications produced under the initiative reflect the consensus of All.Can members who have full editorial control.
The All.Can initiative in Canada is made possible with financial support from Bristol Myers Squibb Canada (main sponsor), Merck Canada, Roche, Johnson & Johnson, AstraZeneca, Amgen, Novartis and Sanofi.
None of the content developed in discussions and activities of the All.Can initiative contains direct or indirect references to specific medicinal products or therapies. Use of content from this website is permitted provided that the source of information is clearly mentioned.