Cancer remains the leading cause of death in Canada. An estimated two in five Canadians will be diagnosed with cancer in their lifetime and about one in four will die from cancer. In 2023, the most recent statistics we have, it was expected that 239,100 Canadians will be diagnosed with cancer and 86,700 will die from the disease.
This is why it was so surprising that a February World Health Organization (WHO) report on cancer went largely unnoticed and unremarked upon. The report predicts a staggering global increase in cancer cases of 77 per cent by 2050.
What’s Canada doing to prepare? Not enough — and certainly nothing with a long-term focus. It’s time our governments crafted a concrete and sustainable cancer preparedness plan.
In addition to the recent WHO report, there are specific cancer predictions for Canada in a 2023 issue of the journal, Preventive Medicine. The authors estimate an increase in new cancer cases of 40 per cent from 2020 to 2040, and by 45 per cent in some of the mostly commonly diagnosed cancers: breast (27 per cent), colorectal (45 per cent), lung (45 per cent) and prostate (34 per cent). These are due to demographic factors including aging of the population, greater longevity, better detection, immigration and the true increased risk of certain cancers.
The authors also project the number of cancer deaths will increase by 44 per cent from 2020 to 2040. The journal article concludes that these estimates highlight the importance of planning for increasing investment and capacity in cancer control in Canada. This is clearly an understatement.
Canada is facing a cancer cataclysm with strategies, tactics and policies that are inadequate to control the present cancer crisis, let alone these dire predictions.
Future estimates can easily sound just like numbers and more numbers. But, no! Each number is a family member, friend, coworker, neighbour, person in stores where we shop — and on and on goes this tragic list. It would be difficult to find anyone in the country who has not known someone in their life who has been impacted by cancer, Canada’s biggest killer.
We must have a long-term preparedness plan. Though we already have not prepared for the predictably increased numbers we face today, we have time to prepare for the upcoming wave; we must not squander it.
To date, both the federal government and our provincial/territorial governments lack a robust and comprehensive cancer control strategy.
So, what do we have?
The federal 2019 Canadian Strategy for Cancer Control is a 10-year action plan which aspires to achieve equitable access to quality cancer care in Canada, and promises to ensure a sustainable system for the future. It has eight priorities, all laudable, and a budget to help meet them — but it’s set to expire in a few years time.
Most of our provinces have cancer programs with similar goals and aspirations. But generally, the plans include tactics to control cancer in specific ways, for specific disease areas, in the short term. There are also limited bilateral health agreements between provinces/territories and the federal government on cancer control. They also have specific and important short-term objectives.
These plans are not going to prepare us for a cataclysm — they are not even adequate for today’s cancer reality. They are not fit for purpose. None of these existing plans constitutes a country-wide, coordinated and sustainable long-term cancer preparedness strategy, which is what we need.
The cancer plan must be comprehensive, created in collaboration with all relevant stakeholders and experts. It must include increased investment and capacity in cancer control. And it must be heavily weighted toward prevention, early diagnosis and appropriate testing and treatments. Prevention is always sorely underfunded.
We need a realistic plan that recognizes discrete strategies for different cancers. In order to ensure early diagnosis, we also need direct, effective pathways from a first doctor’s visit to diagnosis. Governments must pay for proven tests and treatments, thereby saving significant amounts in other parts of the healthcare budget through prevention and early diagnoses.
By investing wisely and equitably, cancer cases and deaths could be prevented.
What it must not be is a political exercise, considering short term “wins” for political gain. It must be a properly resourced and coordinated multisectoral, multidisciplinary approach based on relevant data.
The WHO has sounded the alarm with plenty of time for us to prepare. If we do nothing different than present tactics, the Cassandra-like warnings of WHO will surely come true.
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