Cancer Care Ontario Releases Action Plan for Improving Provincial Cancer Services



    Cancer services better today, action needed to meet a 40 per cent
    increase in cancer patients in next 10 years

    TORONTO, March 20 /CNW/ - Cancer Care Ontario today released the
2008-2011 Ontario Cancer Plan, an action plan designed to boost cancer
screening rates, improve access to diagnostic and treatment services, make
cancer services better and safer, and put new cancer research into practice,
faster.
    "More people are surviving cancer and cancer services are better today
than ever because of actions that have been taken in recent years," says
Terrence Sullivan, President and CEO, Cancer Care Ontario. "We cannot afford
to be complacent because 40 per cent more people will be living with cancer in
the next decade. By working with our partners to take the steps set out in the
Ontario Cancer Plan, fewer people will get cancer and more will survive a
diagnosis and receive better services, every step of the way."
    The 2008-2011 Ontario Cancer Plan is a three-year road map for the
province's cancer system. It sets out the actions that need to be taken to
control cancer and improve patient care. This is the second Ontario Cancer
Plan. The first plan was released in 2004.
    "We have made huge gains in the fight against cancer since the first
Ontario Cancer Plan," said George Smitherman, Deputy Premier and Minister of
Health and Long-Term Care. "In the last five years our government has added
more quality services for patients suffering with cancer. This has reduced
wait times significantly and has allowed patients to get quality cancer care
closer to home. We will continue to work side by side with Cancer Care Ontario
and health providers on the front lines to lessen the toll of cancer."
    The 2008-2011 Ontario Cancer Plan has six goals and highlights four key
actions that will have the greatest impact on cancer in the next three years:

    
    1.  Boosting cancer screening rates through aggressive education about
        screening, providing tools to help primary care providers and
        patients participate in screening, including using IT to send
        invitations, reminders and prompts about screening. Cancer Care
        Ontario will work with our partners to reach under-screened groups
        including low income earners, new Canadians, people without a family
        physician and Aboriginals.

    2.  Improving the time to diagnosis by beginning to measure and set
        targets for the wait time between a referral from a family physician
        to when the patient sees a specialist for tests.

    3.  Raising the quality of regional cancer services through implementing
        improvements including; providing better access to chemotherapy in
        community hospitals, closer to home; making highly complex
        chemotherapy and lung surgery safer; and making intensity modulated
        radiation therapy (IMRT) the gold standard radiation therapy.

    4.  Ensuring the high quality and safe introduction of tests that can
        predict people's response to treatment and cancer risks, and enable
        individualized therapy - referred to as molecular medicine.

    Significant progress has been made since the first Ontario Cancer Plan.
Wait times for radiation and cancer surgery have been steadily going down;
regional cancer services and centres have greatly expanded; there are fewer
smokers because of Smoke-Free Ontario Act; and the colorectal cancer screening
and HPV vaccination programs will save lives.

    Growing Number of People with Cancer, Need for Services

    -   Close to half of all people will develop cancer in their lifetime:
        44 per cent of men and 39 per cent of women.

    -   Sixty per cent of cancer patients survive 5-years or more after a
        cancer diagnosis, up from less than half two decades ago. Almost all
        prostate cancer patients and 90 per cent of breast patients live more
        than five years after a diagnosis.

    -   In 2007 the province spent $176 million on 27,000 intravenous
        chemotherapy treatments. In 2011- 2012, it is projected that Ontario
        could spend an estimated $446 million on 49,000 chemotherapy
        treatments.

    Cancer Care Ontario continually improves cancer services so that fewer
people get cancer and patients receive better care.


    BACKGROUNDER

                       Ontario Cancer Plan: 2008 - 2011

    What is the 2008-2011 Ontario Cancer Plan (OCP)?

    The 2008-2011 Ontario Cancer Plan is a three-year roadmap for the
province's cancer system. It sets out the actions that need to be taken to
reduce the number of people diagnosed with cancer and improve the quality of
patient care. It spans every phase of cancer.

    What is the focus of the OCP?

    The 2008-2011 Ontario Cancer Plan has six goals:
    1.  Reduce the number of people diagnosed with cancer
    2.  Reduce the impact of cancer through effective screening and early
        detection
    3.  Ensure timely access to effective diagnosis and high quality cancer
        care
    4.  Improve the patient experience at every step of the cancer journey
    5.  Improve the performance of Ontario's cancer system
    6.  Strengthen Ontario's ability to translate cancer research into
        improvements in cancer control and cancer services

    Out of these goals, there are four key initiatives that will have the
greatest impact on cancer control and care.
    The four key initiatives are:
    1.  Transform cancer screening programs to boost early detection rates
    2.  Speed up and streamline cancer diagnosis
    3.  Raise the quality of regional cancer services through the development
        of Regional Cancer Programs and by making sure the people and
        infrastructure are in place to improve quality, safety and wait times
        for cancer services
    4.  Prepare Ontario's response to and make best use of emerging advances
        in molecular oncology - tests that can predict people's response to
        treatment and cancer risks, and enable individualized diagnosis and
        treatment of cancer

    Why is the Ontario Cancer Plan important?

    Over the next 10 years Ontario will see an unprecedented rise in the
number of people with cancer largely because we have an aging and growing
population.

    -   Close to half of all people will develop cancer in their lifetime:
        44% of men and 39% of women.
    -   In the next 10 years, Ontario will see a 40% increase in the number
        of people living with cancer.
    -   In 2007, 172 people in Ontario were diagnosed with cancer each day.
        By 2017, that number of newly diagnosed cases is expected to jump to
        228 per day, unless there are significant changes to cancer
        prevention.
    -   Cancer drug spending is rising dramatically - because of demand
        (patients taking multiple therapies, more treated for 2nd and 3rd
        cancers) and because the cost of individual drugs has skyrocketed. In
        2007 the province spent $176 million on 27,000 intravenous
        chemotherapy treatments. In 2011-2012, it is projected that Ontario
        will spend about $446 million on 49,000 chemotherapy treatments.
        That's nearly double the number of treatments and over double the
        spending in three years.
    

    Cancer is a disease we can do something about. We can prevent some
cancers and detect a number of them early. By planning ahead and taking
action, we can make care safer and better for patients.
    Over the last few years we've taken a number of actions that have
produced real improvements, particularly in cancer treatment, we have put a
strong foundation in place, but, we have just begun.
    Ontario continues to have significant challenges. The process for
diagnosing cancer is difficult and confusing for patients and we do not have a
way of knowing how long people are waiting for diagnostic tests. Ontario's
screening rates are too low. Funding and access to cancer drugs will continue
to be a challenge.

    What progress has been made since the first Ontario Cancer Plan was
    released in 2004?

    Ontario has made substantial advances in cancer control since the first
Ontario Cancer Plan in 2004.
    Over the last three years we've put a strong foundation in place by
introducing new prevention and screening programs, by expanding regional
cancer services, by improving treatment wait times and by getting health
professionals and organizations to work together to continually improve the
quality of cancer services. Key successes include:

    
    -   Breakthroughs in cancer prevention and screening
        -  Smoke-Free Ontario: ColonCancerCheck, Ontario's colorectal cancer
           screening program; and the HPV vaccination program.

    -   Improving access to and quality of cancer services
        -  Radiation wait times down 31 % in three years (2003-2006).
        -  More cancer centres have been built, expanded and committed to in
           the last three years than ever before in Ontario.

    -   Improving system performance
        -  Launch of the Cancer System Quality Index, the first online report
           card of its kind in Canada that reports yearly on how the system
           is performing.
        -  Ontario is a leader in using information technology to improve
           patient safety and quality of care, and the overall performance of
           cancer services.
           -  Computerized Physician Order Entry - an online cancer drug
              ordering system that reduces drug errors caused by
              misinterpretation of handwritten prescriptions and dosage
              calculations. 60% of all drug orders made using CPOE.
           -  The Wait Times Information System - Ontario's single
              information system to collect accurate and timely wait time
              data. Patients and their primary health care providers can also
              access the information to make informed choices together about
              where to be referred for quicker service.
           -  Interactive Symptom Assessment and Collection, a tool that
              allows palliative patients to track and report symptoms on-line
              to their health care team is being used by every regional
              cancer centre and Community Care Access Centre.

    What specific actions are being proposed in the 2008-2011 Ontario Cancer
    Plan?

    Goal 1: Reduce the incidence of cancer

    Up to 50% of cancers could be prevented. The best way to gain an upper
hand is to prevent it and detect it early.
    We will continue to tackle tobacco and inactivity, poor nutrition and
obesity - the biggest known cancer risk factors - through contributing to the
Smoke-Free Ontario strategy and spearheading cancer-specific strategies to
reduce cancer risks.

    -   We will develop effective healthy living strategies for reducing
        cancer risks.

    -   We will work with the Ontario government and other partners to better
        understand the role of occupational and environmental carcinogens so
        that we can develop more effective strategies to reduce harmful
        exposures. Cancer Care Ontario will focus on surveillance and
        research to understand at what levels of exposure different
        carcinogens pose a risk.

    Goal 2: Reduce the impact of cancer through effective screening and early
    detection

    We can make some of the most significant gains in cancer by detecting it
early.
    Last January, the province launched ColonCancerCheck, a province-wide,
population-based colorectal screening program, the first of its kind in
Canada. It provides:

    -   Wider access to people 50 and over with an easy-to-use test called
        the Fecal Occult Blood Test through primary care physicians and, for
        people without a primary care provider, through pharmacies and
        Telehealth. It also provides more colonoscopies for people at
        increased risk because of a history of colorectal cancer in their
        immediate family.
    -   Primary care practitioners with the supports they need to screen
        patients including education and improvements to the patient referral
        and follow-up processes.
    -   A large scale public education campaign.
    -   Information technology to support self-care and improve clinical
        management, including invitations to participate, reminders and
        recalls for individuals 50 and over to get screened and prompts for
        their primary care practitioners.

    Screening for breast and cervical cancers is saving lives in Ontario. But
screening rates have stalled in recent years.

    -   Building on ColonCancerCheck, Cancer Care Ontario intends to work
        with the government and other partners to create an integrated and
        organized program for all cancer screening aimed at boosting
        screening rates. This program will be more efficient, convenient for
        health care providers and for individuals and will target hard-to-
        reach populations including new Canadians, low income earners, people
        without a family physician and Aboriginals.

    We expect to see the following outcomes by 2010:
    -   Mammography screening of 70% of Ontarian women aged 50 to 69 years
        old - up from today's participation rate of 60%
    -   Cervical screening of 85% of eligible Ontarians, representing
        15% increase in three years
    -   Colorectal screening of 40% of eligible Ontarians, representing a
        23% increase in three years

    Goal 3: Ensure timely access to effective diagnosis and high quality care

    Cancer Care Ontario will focus on improving access to diagnostic services
by beginning to measure and tackle the wait time between when a patient is
referred from a family physician to when they see a specialist for tests.

    -   We will begin by setting targets and measuring waits for diagnostic
        assessment of colorectal cancer.
    -   Our aim is to have at least one diagnostic assessment program in
        every Local Health Integration Network.
    

    Wait times for chemotherapy are not improving and the demand for cancer
drugs is outpacing our human and physical resources. We need to change the way
we deliver chemotherapy by providing more chemotherapy in community hospitals,
closer to home and ensuring chemotherapy services are of consistently high
quality and safe in every setting.
    CCO is leading an initiative to improve access and safety of chemotherapy
in every area of the province. Through this initiative more routine
chemotherapies can be delivered in community hospitals, closer to home, while
more complex treatments will be delivered in larger cancer centres that meet
quality standards.
    Cancer Care Ontario will help prepare for the safe and quality
introduction and use of molecular oncology tests that predict people's
response to treatment and cancer risks and enable us to better target
therapies to individual patients. Cancer Care Ontario is bringing leaders from
different oncology disciplines and laboratory medicine to form a task force
with the goals of ensuring consistent quality standards and assurance for
these new tests and equitable access to services including genetic testing
across the province.

    Goal 4: Improve the patient experience across the continuum of care

    We need to continually look at the entire cancer experience from the
patient's perspective to ensure that they are informed, supported and involved
in their care.

    
    -   Cancer Care Ontario will develop a strategy to better understand,
        measure and improve the experience of the patient at every phase of
        their cancer journey.
    -   Cancer Care Ontario has launched a Provincial Psychosocial Oncology
        program aimed at improving the quality and availability of services
        to meet the psychological and emotional needs of cancer patients.
    -   By expanding the use of ISAAC, a tool that allows palliative patients
        to track and communicate their symptoms to their care team remotely
        through kiosks and their home computer, we will continue to improve
        the quality of palliative care.

    Goal 5: Improve the performance of Ontario's cancer system

    CCO is committed to making sure that the cancer system is continually
improving and accountable.
    Ontario has nationally and internationally recognized expertise in
creating information systems that support health professionals, improve the
safety and experience of cancer patients and overall system performance.

    Over the next three years we will:
    -   Harness information technology to support patients and primary care
        practitioners to participate in screening.
    -   Target 90% of chemotherapy treatments ordered online instead of
        error-prone paper prescriptions.
    -   Provide more accessible web-based information to patients about wait
        times and other aspects of cancer services so they can better manage
        their own care.

    Goal 6: Strengthen Ontario's ability to translate cancer research into
    improvements in cancer control

    Cancer Care Ontario will continue to focus on ensuring that new research
findings and discoveries are rapidly applied to improve cancer prevention and
clinical practice.

    -   Cancer Care Ontario and the Ontario Institute for Cancer Research are
        poised to launch the Ontario Cancer Cohort, a province-wide study of
        over 100,000 Ontarians to better understand the causes and risks of
        cancer and other major diseases such as heart disease.

    The Ontario Cancer Plan: 2008-2011 is available on Cancer Care Ontario's
website at www.cancercare.on.ca


    Cancer Care Ontario
    Backgrounder
    -------------------------------------------------------------------------

    Cancer Care Ontario is the provincial agency responsible for continually
improving cancer services. As the government's cancer advisor, Cancer Care
Ontario:

    -   Directs over $600 million public health care dollars to hospitals and
        other providers for cancer services and evaluates their performance
        to ensure Ontarians receive results.
    -   Implements provincial cancer prevention and screening programs
    -   Sets and implements standards and other quality improvements
    -   Uses information and technology to support health professionals and
        patient self-care and improve the performance of the cancer system
    -   Plan cancer services to meet current and future patient needs
    -   Applies new research to innovate and improve patient care and cancer
        services.
    

    Regional Cancer Programs

    Regional Cancer Programs are the networks of stakeholders, healthcare
professionals and organizations involved in cancer prevention and care within
each of the province's 14 Local Health Integration Networks. Each is led by a
Cancer Care Ontario Regional Vice President. The Regional Cancer Programs were
established in 2005 to respond to local cancer issues and needs, to act on
provincial standards and programs locally, and to improve access, wait times
and quality by managing and coordinating care across local and regional
healthcare providers.




For further information:

For further information: Jennifer Obeid, Sr. Manager of Media Relations,
Cancer Care Ontario, t: (416) 971-9800 ext. 3383, c: (416) 917-9851, email:
jennifer.obeid@cancercare.on.ca, www.cancercare.on.ca


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