2009 Quality Index Reports on Ontario's Cancer System
TORONTO, April 28 /CNW/ - Despite improvements to the cancer system
including lower smoking rates and better screening and care for colorectal
cancer patients, this year's Cancer System Quality Index also reports that the
increasing burden of cancer is beginning to strain parts of the cancer system.
"The overall quality of the cancer system is very good with many
indicators showing improvements each year," said Michael Decter, Chair, Cancer
Quality Council of Ontario. "At the same time, there is still room for
improvement. We continue to see higher obesity rates and a significant number
of the population not following low-risk drinking guidelines that we know
raise a person's risk of cancer. As a society we are still not doing enough
and require greater commitment on the part of Ontarians, governments, and
health professionals to promote healthier lifestyles and modify behaviours."
More than half of all cancers are preventable and about half of cancer
deaths are related to tobacco use, diet and physical activity. However, while
Ontarians are more physically active (48 per cent) and consuming more fruits
and vegetables (42 per cent) than in 2001, at 17 per cent of the population,
the obesity rate continues to be a concern.
The Index shows gains being made in the fight against colorectal cancer,
the second leading cause of cancer deaths in Ontario. Significant progress has
been made towards improving screening, diagnosis and treatment for colorectal
cancer patients, which are all contributing to better survival rates. In the
past year, screening for colorectal cancer increased by 30 percent and
diagnostic colonoscopies are being completed in a timely manner. Survival for
colorectal cancer has increased to 62 per cent -- up 11 per cent from the
"I am pleased to see the progress Ontario is making in screening for
colorectal screening. The Ontario Government's commitment to the
ColonCancerCheck program is making a difference. If detected early enough,
there is a 90 per cent chance of surviving colorectal cancer, so that's why
screening and early detection are so critical. We have a ways to go but we are
on the right track," said Terrence Sullivan, President and CEO, Cancer Care
The increasing burden of cancer is largely attributed to an ageing
population and it is beginning to impact the capacity of the system. An area
where the cancer system is starting to show signs of strain is chemotherapy.
Until now, Ontario has been able to keep wait times for chemotherapy in check.
However, the Index shows that wait times for chemotherapy are starting to
"Cancer Care Ontario is looking at ways to maximize resources to ensure
that patients receive timely access to chemotherapy as close to home as
possible," noted Sullivan. "We are working with the regions and the Ministry
of Health and Long-Term Care to address this issue."
Other highlights from the Cancer System Quality Index include:
- Despite most patient wishes, over half of Ontario cancer deaths
occurred in an acute care hospital setting, but these numbers are
beginning to decrease. In addition, over 40 per cent of cancer
patients are visiting the emergency department for pain and symptom
control in the last two weeks of their life.
- Wait times for cancer surgeries show some modest improvements, but
variation exists across regions in their ability to meet targets for
the higher priority surgeries (priority two and three cases).
- With the exception of lung cancer survival, rates for the 4 most
common cancers (prostate, breast, colon and lung) have significantly
improved since 1991-1995. Too many lung cancer patients (78 per cent)
are diagnosed in the later stages of the disease (stages three or
- The vast majority (97 per cent) of cancer patients treated in
outpatient units continue to report a reasonably high degree of
satisfaction with most aspects of their care. While scores for
emotional support, remain lower (this indicator was rated as
satisfactory by only 51 per cent of cancer patients).
The Cancer Quality Council of Ontario monitors and reports to the public
on the quality and performance of the cancer system. The Cancer System Quality
Index was launched in 2005 and presents a rolling snapshot of activity in 29
key indicators that cover the spectrum of cancer services, from prevention
through to end-of-life care.
Cancer Care Ontario is the provincial agency responsible for continually
improving cancer services. As the government's cancer advisor, Cancer Care
Ontario works to reduce the number of people diagnosed with cancer and make
sure that patients receive better care every step of the way.
For more information visit: www.csqi.on.ca.
2009 Cancer System Quality Index Backgrounder
What is the Cancer System Quality Index?
The Index is a web-based public reporting tool that serves as a valuable,
system-wide monitor that allows us to track the quality and consistency of all
key cancer services delivered across the spectrum of Ontario's cancer system,
from prevention through to end-of-life care.
It is an important tool used by health professionals and cancer
organizations, planners and policy makers to identify cancer trends and to
plan and make improvements in all areas of cancer prevention and care.
Now in its fifth year, the Index presents a rolling snapshot of activity
in about 30 key indicators that cover the spectrum of cancer, from prevention
to end-of-life care (e.g., smoking rates, obesity, colorectal, cervical and
breast screening rates, cancer surgery, radiation and chemotherapy wait times,
treatment quality, and measures of patient satisfaction and survival).
A North American first, the Index was launched in 2005 by the Cancer
Quality Council of Ontario, in partnership with Cancer Care Ontario (CCO).
Each indicator is a specific measurement of progress against one of six
goals - each established to help us focus our efforts in improving the cancer
1. Increased action on prevention
2. Improved access to services
3. Better outcomes
4. Use of evidence when treating cancer
5. Greater efficiency
6. Improved measurement
29 Indicators - This online Index presents new data for each of 29 key
indicators. New indicators relate to treatment quality, including modification
to the way in which systemic therapy and surgical wait times are reported, and
the addition of a dimension of equity to prevention measures.
Key Findings - This feature provides a high level snapshot of the
performance of the system, broken down by cancer system goal, highlighting
where the system is doing well, and what areas need on-going improvement.
Four Stories from the 2009 Cancer System Quality Index - Using two
different types of cancer (colorectal and lung); as well as two phases of the
patient journey (treatment and end-of-life care), this area highlights what is
working well and what needs improvement from a patient and system perspective.
Local Health Integration Network (LHIN) Based Analysis - The Index also
presents cancer system performance within each of Ontario's 14 LHINs and
presents a snapshot view of how each LHIN is doing in terms of wait times and
In addition to the efforts of Cancer Quality Council of Ontario and
Cancer Care Ontario, the following partners made significant contributions to
this year's Index:
- Institute for Clinical Evaluative Sciences
- Ontario Institute for Cancer Research
- Division of Cancer Care Epidemiology, Queens Cancer Research
Parts of this report are based on data and information compiled and
provided by the Canadian Institute for Health Information (CIHI). However, the
opinions and statements expressed on the website are those of the report's
authors, and not necessarily those of the Canadian Institute for Health
For further information:
For further information: Lenore Bromley, Senior Public Affairs Advisor,
Cancer Care Ontario, (416) 971-9800 ext. 3383,