For more than a year now, health and cancer systems across Canada have been responding to the COVID-19 pandemic. It has been a very vulnerable time for people with cancer, and the Partnership has worked tirelessly with partners to sustain, restore and redesign services affected by COVID-19.
This annual report highlights the Partnership’s work with partners to not only support the restoration of cancer services disrupted by COVID-19, but also accelerate the adoption of new practices to advance patient care and deliver on the priorities and actions of the Canadian Strategy of Cancer Control.
2020/21 Year in review
Current initiatives are advancing the Strategy and helping the cancer system continue to innovate in response to COVID-19.
Expanding access to palliative care across Canada
Introducing high-quality palliative care early can help people live more fully and comfortably throughout their cancer journey. For people receiving end-of-life palliative care, most would prefer to remain at home with appropriate support. A new model of care is training paramedics to assess and treat patients with palliative care needs at home instead of going to the emergency department. With joint support from the Partnership and Healthcare Excellence Canada, the model is now being rolled out in 10 jurisdictions. In response to the pandemic, the initiative is expanding to try to keep patients out of hospitals whenever possible. Over 4,400 paramedics have been trained to date, and more than 7,000 paramedics will be trained by 2022.
Despite the growing need for palliative care services, there aren’t enough health professionals with the necessary skills and knowledge to provide palliative care. To address this gap, the Partnership collaborated with Health Canada, the BC Centre for Palliative Care and Pallium Canada to develop the Canadian interdisciplinary palliative care competency framework. The framework builds on existing frameworks to establish a national standard to deliver high-quality palliative care across all settings—cancer centres, palliative care clinics, long-term care, primary or home care.
Accelerating the development of lung cancer screening programs
Lung cancer is the most common – and deadly – cancer in Canada, but screening those at high risk for lung cancer can reduce deaths by up to 24 per cent. The Partnership is providing $5 million to support partners to speed the planning and development of lung cancer screening programs. New programs will include a strong emphasis on First Nations, Inuit and Métis peoples, individuals with lower income and people living in remote and rural areas. The Partnership’s recent report Lung cancer and equity: A focus on income and geography found alarming differences in access to lung cancer care among these communities. For example, people with lower income are nearly twice as likely to be diagnosed with lung cancer than those with higher income and are less likely to survive. And First Nations adults are 35 per cent less likely than non-Indigenous populations to survive lung cancer five years after diagnosis.
Increasing participation in colorectal cancer screening
Colorectal cancer is the third most diagnosed cancer and second leading cause of cancer death in Canada, yet participation rates for screening programs remain stubbornly low. COVID-19 further compounded the problem, as screening programs paused or reduced their capacity. However, changes are underway across the country that will help programs expand their reach — particularly to groups that experience inequities in access. The Partnership is supporting jurisdictions across Canada to work with First Nations, Inuit and Métis and underserved populations to understand barriers that prevent people from accessing colorectal cancer screening programs. Despite pandemic-related delays, efforts to engage these communities have already begun. For example, Alberta is working with groups like Calgary’s Punjabi Community Health Services to recruit participants for online focus groups to problem-solve together.
To help partners identify communities with particularly low screening rates, the Partnership developed a geo-mapping tool and trained jurisdictions in its use. A new toolkit, Equity-focused interventions to increase colorectal and cancer screening: Program pack, provides interventions to address the barriers faced by these communities.
Eliminating cervical cancer
Partners across the country are actively working on Canada’s ambitious goal to eliminate cervical cancer by 2040. Launched in November 2020, the Action plan for the elimination of cervical cancer in Canada calls for immediate action on several priorities, including improving HPV immunization rates and implementing primary HPV screening. To reach the goal of 90 per cent of 17-year-olds vaccinated against HPV by 2025, the Partnership is providing $1.6 million to help jurisdictions improve vaccination rates and, understand the needs and barriers that prevent First Nations, Inuit and Métis and underserved communities— from participating in existing vaccination programs.
The Partnership is also providing $1.4 million to support shifting from Pap tests to the HPV test, which is more effective at detecting pre-cancers. HPV primary screening can include self-sampling, which enables people to collect their sample at home or in a clinic setting. When a test is administered at home, it reduces the need for in-person interactions with the health system, a particular concern during the COVID-19 pandemic.
Helping patients with cancer to quit smoking
Patients with cancer who stop smoking can lower their risk of dying by about 40%. While 87 per cent of cancer centres have implemented smoking cessation supports across the country, cancer centres faced a challenge this year when COVID-19 severely limited in-person visits for smoking cessation counselling. In response, the Partnership helped partners adapt their approach by providing additional funding to explore new options to support patients, including smoking cessation counselling by telephone and mailing out nicotine replacement therapy (NRT).
Better access to smoking cessation medications will remain a priority even after pandemic restrictions loosen to address gaps in coverage and help those who don’t qualify for subsidized or free treatment. Cancer centres across the country continue to partner with First Nations, Inuit and Métis organizations and communities to expand the availability of culturally appropriate smoking cessation supports. Supports include a Partnership-funded, Indigenous-specific quitline, Talk Tobacco, that was launched in Ontario by the Canadian Cancer Society and has now expanded to Saskatchewan and Manitoba. The quitline provides culturally safe smoking cessation support in 24 Indigenous languages.
Improving cancer care for First Nations, Inuit and Métis
Canada’s refreshed cancer strategy commits to closing gaps in cancer care by supporting health equity for First Nations, Inuit and Métis. The Partnership is funding 29 partners — 20 of them First Nations, Inuit and Métis organizations — to take action on Peoples-specific, self-determined priorities through planning or implementing cancer plans in all 13 provinces and territories. The plans will improve the cancer journey and outcomes for First Nations, Inuit and Métis, while addressing the need for culturally safe care across the country.
For example, in Nova Scotia, the Union of Nova Scotia Mi’kmaq has implemented a youth healthy living social media campaign with a focus on smoking cessation and prevention. In the Northwest Territories, partners are working with the Government of Northwest Territories Health and Social Services to implement an organized colorectal cancer screening program that uses a Peoples-specific approach.
In this together
With the refreshed Strategy as our guide the Partnership will continue to create alignment across Canada to achieve our strategic priorities, sustain a world-class cancer system through innovation and create an accessible, equitable cancer system for all people in Canada.
We remain in this together.