The Canadian Partnership Against Cancer has released two new reports which provide the country’s first evidence-based, comprehensive national standards for gynecologic oncology and thoracic surgery that can be adapted to local health systems.
The Pan-Canadian Standards for Thoracic Surgery and Pan-Canadian Standards for Gynecologic Oncology were developed in response to the tremendous variability in how each province delivers cancer care services, as demonstrated in the 2015 report, Approaches to High-Risk, Resource Intensive Cancer Surgical Care in Canada.
These standards aim to provide high-level guidance and discussion on the foundational resources and requirements needed to improve surgical cancer care and patient outcomes. Both reports emphasize a number of key areas, including human resource requirements to ensure timely access to care, the availability of required equipment and services, quality assurance processes and measurement capabilities. The development of these standards was informed by environmental scans, a literature review and expert consensus.
Pan-Canadian Standards for Thoracic Surgery
According to the Canadian Cancer Society, lung cancer kills more people than prostate, colon and breast combined, and currently accounts for 26 per cent of all cancer deaths in Canada. Surgery is the optimal curative option for this deadly disease, however it is associated with a high risk of adverse outcomes due to the particular complexity of lung cancer.
The Pan-Canadian Standards for Thoracic Surgery recognize thoracic surgery as a ‘team sport’, and emphasize the need for the entire health care team to be well-trained and adequately resourced to provide the best possible care to Canadians.
Modern day thoracic surgery is extremely complicated and good outcomes can no longer be expected from an unsupported specialist working in a vacuum. The [Pan-Canadian Standards for Thoracic Surgery] encapsulate modern thinking on the delivery of high quality, cost-effective, safe care for patients with thoracic malignancies and clearly show the importance of systems and infrastructure which are absolutely necessary for good outcomes.
– Drew Bethune MD FRCS(C), Medical Director Nova Scotia Cancer Programme, Past President Canadian Association of Thoracic Surgery
The report highlights the need for quality processes, such as routine data collection and the development of a national database, to be thoughtfully embedded into existing health care processes to support continuous quality improvement. In addition, careful consideration should be given to regionalizing specialized services, while accounting for patient choice and travel time.
…With the ability to be tailored to local health systems, these standards will promote excellence in patient centred care [and] foster the development of innovative high quality treatment for patients suffering [from] complex benign and malignant thoracic diseases.
– Sean Grondin, President, Canadian Association of Thoracic Surgeons (CATS)
The document also recognizes the importance of key supports from human resources and allied health professionals to collaboratively elevate the delivery of thoracic surgical care in Canada.
Pan-Canadian Standards for Gynecologic Oncology
According to Statistics Canada, in 2010, 12 per cent of all cancers diagnosed in Canadian woman involved the reproductive system. Ovarian malignancies were the most fatal, causing 9.5 deaths per 100,000 women. Ovarian cancer resections also constituted the second highest case volume across Canada, however there was significant variability in resection rates and patient outcomes among provinces.
The Pan-Canadian Standards for Gynecologic Oncology emphasize an integrated, multidisciplinary approach to gynecologic oncology surgery. The delivery of care should be a shared responsibility between collaborating specialties, where they collectively evaluate treatment options.
The Society of Gynecologic Oncologists of Canada (GOC) enthusiastically endorses the [Partnership’s] standards and welcomes the opportunity to harmonize the treatment for women across our country within specialized centres. In this era where “technology cures and care heals”, our system needed this in-depth evaluation of the standards necessary to provide equal and high-quality treatments for all women in Canada.
– Walter H. Gotlieb, MD, PhD. President, Society of Gynecologic Oncologists of Canada (GOC)
The team treating gynecologic malignancies should be well-trained and adequately resourced to provide the best possible care to women with gynecologic malignancies to ensure that even the most vulnerable populations are receiving high-quality care.
This national document will set the standard for best practice and patient care for women with a gynecologic malignancy.
– Prafull Ghatage, Gynecologic Oncologist, Tom Baker Cancer Centre
Health care planners and providers can use these standards to organize care in a way that maximizes patient outcomes while providing optimal care to Canadian women with gynecologic malignancies.
Read the Reports
View the full report, Pan-Canadian Standards for Thoracic Surgery.
View the full report, Pan-Canadian Standards for Gynecologic Oncology.