Progress Report on Cancer Control in Canada

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Conclusions and Future Directions

This Progress Report on Cancer Control in Canada shows that there have been substantial changes in cancer control over the past several decades.

In many areas, significant progress has been made. Taken as a whole, mortality rates for all cancers combined have declined among both men and women since the late 1980s, primarily as a result of decreasing mortality rates from breast, prostate and colorectal cancer. Changes in diet are believed to at least partly explain declines in colorectal cancer, while, in general terms, people with cancer are surviving longer as a result of early detection and improved treatments.

Perhaps the most important progress has been the falling prevalence of cigarette smoking. This has led to declining lung cancer rates in males, and it is anticipated that similar declines for females will be observed within the next decade. Progress in this and other areas is attributable in large part to effective cancer prevention initiatives. Recent genetic research holds promise for better treatments in the future.

Despite these successes, Canada faces significant challenges in cancer control. Although there is much that we do not know about the causes of cancer, there is much that we do know but are failing to apply.

While incidence rates for some cancers in Canada are falling, the absolute numbers of new cases requiring treatment is increasing by approximately 3% per year due to the growth and aging of the Canadian population. This demographic trend will accelerate over the next decade, placing a heavy demand on Canada’s cancer control system. Future cancer control initiatives must therefore address the need for increased treatment capacity and better integration of palliative care programs across the country.

Improved efforts in cancer prevention are critical to future success in cancer control. Federal, provincial/territorial and municipal governments, along with non-governmental organizations across society, are taking the prevention message to Canadians through a broad population health approach, stressing healthy lifestyles as the best means of preventing cancer and other chronic diseases. Work must continue to ensure that disease prevention and health promotion become ingrained as basic societal values.

On a larger scale, by means of the Canadian Strategy for Cancer Control, there is a movement to better integrate cancer control activities through both national and provincial cancer control planning. Efforts are also being made to develop more coherent approaches that incorporate improved surveillance and the identification and implementation of best practices in prevention and control.

Future directions in key activity areas

Prevention

• More research into the causes of cancer and the effectiveness of prevention programs will enhance the evidence base for the development of more effective programs and services.
• We need to better apply what we currently know to help individuals make appropriate lifestyle choices, such as consuming healthier diets, becoming more physically active, not smoking cigarettes, and maintaining healthy body weights.

Screening

• Efforts should be made to increase participation in organized breast and cervical screening programs.
• Determine how best to offer population screening for cancers where there is evidence of effectiveness, but as yet, no organized program.
• Continue research into screening methods for which there is not yet sufficient evidence to advocate their use.

Treatment

• Cancer patients should have improved access to seamless cancer care, where appropriate diagnostic and treatment services are made available with minimal delay.
• The current shortage of oncology specialists should be rectified and training improved to ensure that sufficient specialists are available to cope with the expanding number of cancer patients seeking care.
• Greater participation of adult cancer patients in clinical trials of cancer treatments should be encouraged.
• Efforts should be made to ensure that all cancer patients receive the benefits of established advances in cancer treatment and that these benefits are made available at an affordable cost.

Palliative care

• There should be greater emphasis on promoting wider adoption of the principles of palliative care and on the provision of health professionals with the necessary skills to provide such care.

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