2022-23 Annual report

Cancer screening: Changing the system to save lives

Cancer screening is key to saving lives. Improving how we screen can prevent cancer in some cases and lead to earlier diagnosis and treatment, which gives people a better chance of survival.

For lung cancer, which kills more people in Canada than any other cancer, the argument in favour of screening is clear: evidence shows that screening people at high risk for the disease reduces deaths, largely because cancer is found early.

Colorectal cancer – another leading form of cancer in Canada – can also be prevented through regular screening and is more treatable when caught early. Fecal tests, which are relatively simple for people to self-administer, are a reliable form of screening. But when tests are abnormal, they must be followed by timely access to colonoscopy.

One major challenge is that access to screening and follow-up treatment can be limited in remote or underserviced areas. And significant disparities exist in the rates of screening among different populations across the country.

How partners are solving the challenge

  • Lung cancer screening
    Canada’s cancer strategy has made it a priority to establish organized lung cancer screening programs across the country. The Partnership is funding lung cancer screening planning and implementation in many provinces that is creating real momentum and change across the health system.
  • Colorectal cancer screening
    The Partnership has funded multiple initiatives across provinces and territories to increase the number of people screened for colorectal cancer (including creating more equitable access to screening), reduce wait times for colonoscopies and work around the barriers that the COVID-19 pandemic created for colorectal screening.

What we achieved this year

Lung cancer screening for all provinces

provinces funded to plan and implement lung cancer screening

As of this year, the Partnership has funded nine provinces to plan and implement lung cancer screening programs. We expect all provinces will have an organized screening program or be actively working towards establishing lung cancer screening programs within the next one to two years. As highlights:

  • British Columbia launched a province-wide screening program this year, which is a first in Canada.
  • Quebec recruited 3,000 participants for its lung screening pilot.
  • Alberta launched a new two-year pilot project to offer lung cancer screening to 3,000 eligible people.

Supporting consistent, high-quality screening

The Partnership also helps support consistent, high-quality screening programs across the country. As one example, we continued to support the Canadian Association of Radiologists (CAR) and the Canadian Society of Thoracic Radiology (CSTR) to develop an accreditation program for administering lung cancer screening.

To help provinces train radiologists, CAR and CSTR also launched an education program in English and French that focuses on image interpretation, reporting and the benefits of lung cancer screening.

Improving equity in colorectal screening

Low rates of colorectal cancer screening are closely associated with health inequities and barriers to access experienced by specific communities. The Partnership has funded five provinces and territories – Northwest Territories, Alberta, Manitoba, New Brunswick and Newfoundland and Labrador – to co-develop colorectal screening approaches with First Nations, Inuit, Métis and other partners that meet the needs of those communities.

This year, the Partnership produced a series of videos that shared lessons from each community, including the role of strong partnerships, the value of co-designing educational materials, and the importance of understanding cultural appropriateness.

Improving screening and reducing wait times

Six provinces and territories funded by the Partnership – Yukon, Saskatchewan, Manitoba, Quebec, Nova Scotia and Prince Edward Island – have taken steps to improve colorectal screening programs and reduce wait times for colonoscopies for people who receive a positive fecal test. This year:

  • Nova Scotia streamlined its fecal test distribution system, increased the number of colonoscopy bookings following positive fecal tests, and improved how fecal tests and colonoscopies are used to check for colon cancer.
  • PEI’s Colorectal Screening Diagnostic Navigation Project reduced colonoscopy wait times significantly by giving guidance to patients who tested positive on how to follow up. Wait times are down from between 79 and 143 days to an average of 40 days.

Finding solutions amid COVID-19

Partnership funding enabled Alberta, Manitoba and Prince Edward Island to start mailing fecal tests directly to people’s homes during the pandemic. This meant people did not have to visit their healthcare provider to pick up a kit.

Providing a deeper understanding

Understanding current state and good practices in lung, breast, cervical and colorectal cancer screening is critical for making good policy decisions. This year, the Partnership convened networks to share knowledge, and produced a series of environmental scans that summarize data from provincial and territorial screening programs, which support decision making in the provinces and territories.