Canadian Strategy For Cancer Control

Objectives

The Canadian Strategy for Cancer Control 2019 to 2029 provides a coordinated pan-Canadian framework to achieve fewer people developing cancer, more people surviving cancer and better quality of life for people affected by cancer. It seeks measurable improvement over the decade while reducing inequities and sustaining a high-quality cancer system.[1][2][3][4]

• Decrease cancer risk by supporting healthier lifestyles and communities, reducing exposure to carcinogens, preventing and stopping tobacco use, promoting safer alcohol use, diet, physical activity and sun practices, and expanding appropriate vaccination.[5][6][7][8]
• Diagnose cancer faster, more accurately and earlier by strengthening screening, improving access to diagnostic services, addressing diagnostic delays and implementing lung cancer screening for high-risk people.[5][9][10]
• Deliver high-quality, sustainable and person-centred cancer care by adopting standards, multidisciplinary practice, evidence-based treatment and care models that respect patients’ and families’ preferences and values.[5][10]
• Reduce low-benefit tests and treatments and redirect resources towards proven, approved and equitably delivered drugs, technologies and high-value care.[11][10][12]
• Eliminate barriers to needed care for underserviced populations and rural or remote communities, including barriers related to socio-economic circumstances, culture, age, identity, geography and jurisdiction.[11][12][13]
• Provide integrated information, practical support, survivorship services, palliative and end-of-life care for people living with cancer, families and caregivers throughout the cancer journey.[11][14][15]
• Support children, adolescents and young adults at cancer-care transition points through tailored fertility, mental health, peer, psychosocial and rehabilitation support.[11][15]
• Advance research, inclusive clinical trials, linked data systems, digital health and appropriate artificial intelligence to improve prevention, diagnosis, treatment, service planning and equity.[3][16][17]
• Advance First Nations, Inuit and Métis priorities through culturally appropriate care closer to home, Peoples-specific self-determined services, and Peoples-governed research and data systems.[5][18][19][20]

The Strategy recognises that prevention, early diagnosis, effective treatment, supportive care, research and health-system sustainability are interdependent. It identifies cancer research as essential for developing improved prevention programmes, diagnostics, treatments and models of care, and aims to translate evidence into practice across the cancer continuum.[2][3][16]

For First Nations, Inuit and Métis peoples, the strategic direction is grounded in reconciliation, distinctions-based engagement and self-determination. It seeks to address poorer outcomes, racism, culturally unsafe care, financial and travel burdens, jurisdictional barriers and inequitable access to services, while recognising wholistic and trauma-informed approaches to health and wellness.[19][21][20][22]

Implementation

The Canadian Partnership Against Cancer acts as steward of the Strategy, moving it into action, coordinating pan-Canadian priorities, supporting implementation planning and reporting collective progress. Provinces and territories deliver most health-care services, so implementation depends on shared action across a federated health-care system rather than central delivery alone.[1][18][6][23][24]

• Collaborate with federal, provincial, territorial and municipal governments; cancer agencies and programmes; primary care; public health; health professionals; researchers; academic institutions; charities; patient advocates; technology partners; and people living with cancer, families and caregivers.[1][3][7][23]
• Develop and adapt implementation plans with partners, build on provincial and territorial cancer plans, leverage existing networks and infrastructure, share promising practices and transfer effective approaches between jurisdictions.[5][2][6][24]
• Improve access through rapid diagnosis clinics, mobile testing, electronic referrals, telemedicine, virtual care, local shared-care arrangements, patient navigators and community-based services closer to home.[9][12][13]
• Integrate primary, specialist and community care through shared care plans, accessible electronic medical records, psychosocial supports, rehabilitation, mental health, transport, education and employment support.[14][15]
• Strengthen palliative care by integrating it early into cancer services, training institutional and community providers, expanding home-based services and supporting care in the setting chosen by the patient.[15]
• Implement culturally safe, Peoples-determined approaches with First Nations, Inuit and Métis governments, organisations, communities, Elders, knowledge holders, care providers and families.[18][19][21][20]
• Invest in community capacity, including community-based nurses, navigation, communications, interpreters, case management, travel support, technology and local quality-improvement capability.[21][20][22]
• Develop interoperable digital systems, linked health and social data, electronic health records and evidence-based artificial intelligence applications while protecting confidentiality and respecting Indigenous data governance.[16][17][24]

The refreshed Strategy was informed by engagement with more than 7,500 people, including people affected by cancer, professionals, government leaders and underserviced communities. Its delivery model therefore emphasises meaningful participation by patients, families, caregivers and communities alongside clinical, governmental and research partners.[1][3]

Implementation includes performance measurement and learning. The Partnership is expected to monitor priorities, learn from other jurisdictions, set shared measures of success and provide Canadians with annual updates on collective progress. Actions include collecting data on diagnostic gaps, screening uptake and barriers, care standards, patient-reported outcomes and patient experience.[6][9][10][15][24]

First Nations-, Inuit- and Métis-specific data, indicators, outcomes and targets are intended to be determined and governed by the respective peoples. Relevant data collection and research should follow appropriate Indigenous governance principles and ethical processes, supporting accountability for disparities and improvements in cancer care.[18][20][22][23][24]

Health Canada funds the Partnership’s stewardship role, but the supplied material does not specify a total Strategy budget, programme allocations or a costed implementation plan. The approach nevertheless stresses financially sustainable care, including reducing low-value interventions, collaborative procurement of technologies and investment in capacity, research and services where gaps are greatest.[1][2][12][16][17][23]

Monitoring & Evaluation

The Strategy combines pan-Canadian monitoring of measurable progress between 2019 and 2029 with Peoples-specific data governance and indicators for First Nations, Inuit and Métis. The Canadian Partnership Against Cancer is to monitor priorities, support learning across jurisdictions and report progress to Canadians, including through annual updates on collective progress and impact.[5][6][23][24]

• Monitor outcomes and collective progress towards the Strategy’s priorities, using shared targets, measures of success and meaningful impact measures.[5][23][24]
• Report regularly, including an annual update to Canadians on collective progress towards the priorities.[6][24]
• Measure adoption of care standards and practice improvements during 2019 to 2029, and report the results.[10]
• Track screening effectiveness, access, uptake and barriers, particularly for communities that are hard to reach, and collect data on delays from symptom presentation to confirmed diagnosis.[9]
• Strengthen national data capacity through standardised cancer staging information, real-time patient symptom data, linked clinical and population data, and patient-reported outcome and experience measures.[25][14][15][16][17]
• Use linked health, clinical, social, demographic and patient-experience data to review practice, compare care with benchmarks and standards, and identify quality and equity improvements.[16][17]

Reported outcome evidence includes five-year survival of more than 65 per cent for people with cancer, reductions between 2007 and 2018 in lung and colorectal cancer diagnoses, and reductions in prostate and breast cancer death rates.[25]Population projections indicate that cancer cases could rise from more than 200,000 in 2018 to 277,000 by 2030.[26]

First Nations, Inuit and Métis priorities require distinctions-based data collection, research governance, indicators, targets and outcomes determined by the respective peoples.[18][20][22]First Nations priorities include governance over data collection and use, while Métis priorities include safe self-identification and Métis-determined indicators and outcomes.[18][23]Inuit-specific reporting is envisaged through a report card that can include diagnostic and travel waiting times, alongside examination of environmental contamination and cancer risk.[22]

• Establish First Nations-, Inuit- and Métis-governed research and data systems in accordance with relevant information-governance principles and ethical processes.[19][20][24]
• Collect and report Peoples-specific data to identify trends, inequities and gaps, and use findings to improve accountability and services.[18][20][22]
• Include quality-improvement indicators such as patient experience and community knowledge in First Nations-determined programmes and services.[21]
• Protect confidentiality of medical and patient records while enabling appropriate data linkage and exchange.[17]

The available text does not provide a comprehensive Strategy-wide indicator dictionary, detailed evaluation methodology, surveillance protocol or complete timetable for reporting.[5][6][9][10]It also does not name a single formal accountability body beyond the Partnership’s stewardship and its role in monitoring, reporting and overseeing implementation against shared measures.[23][24]

Costing & Financing

Financing is framed primarily around federal support for the Canadian Partnership Against Cancer, sustainable use of public resources and investment needs rather than a costed implementation plan. The Partnership has received Health Canada funding for stewardship since 2007, and Health Canada also supported production of the report.[1][2]

• Support implementation through resources for the Partnership’s stewardship, partner planning and pan-Canadian action.[5][6]
• Redirect resources away from low-benefit tests and treatments towards proven, approved and equitably delivered drugs and technologies.[12]
• Use funding arrangements, technology and other enablers to facilitate cross-jurisdictional specialist care and improve rural and remote access.[13][14]
• Invest in First Nations, Inuit and Métis communities, providers, research capacity, flexible research opportunities and sustainable support to reduce travel and other financial burdens.[19][21][20][22][23]
• Use collaborative procurement of technology to generate cost savings, increase platform consistency and standardise data collection and reporting.[17]

Available economic evidence associates prevention of an estimated 75,000 cancer cases and 50,000 deaths over 10 years with 5.2 billion Canadian dollars in avoided treatment costs and more than 20 billion Canadian dollars in avoided productivity losses, compared with an estimated 50 billion Canadian dollars spent on cancer treatment.[25]The cost of chemotherapy and radiation therapy is reported to have tripled in less than a decade, while rising treatment costs and workforce shortages threaten health-system sustainability.[26]

The Strategy presents prevention, earlier diagnosis, reduction of low-value care, new delivery models and publicly funded care that delivers value for money as routes to financial sustainability.[8][10][23][24]However, the supplied material does not specify a total Strategy budget, programme allocations, quantified funding gap, financing envelope, detailed resource-mobilisation targets, costing methodology or economic assumptions.[1][9][16][4]