Canadian Strategy For Cancer Control

Objectives

The Canadian Strategy for Cancer Control 2019–2029 seeks to reduce the burden of cancer so that fewer people develop cancer, more survive it and people affected by cancer have a better quality of life. It pursues equitable access to high-quality prevention, diagnosis, treatment, supportive care and end-of-life services through coordinated pan-Canadian action.[1][2]

• Prevent cancer by reducing tobacco use and exposure to carcinogens, supporting healthier diets, safer alcohol consumption, physical activity and sun practices, and expanding appropriate vaccination, genetic testing and proven preventive surgery.[3][4]
• Detect and diagnose cancer earlier by improving symptom recognition and primary-care support, strengthening breast, cervical and colorectal screening, reducing diagnostic delays, and implementing lung cancer screening, particularly for high-risk and underserved communities.[4][5]
• Deliver sustainable, evidence-based and person-centred care by applying standards and clinical guidelines, reducing low-benefit interventions, widening access to high-value tests and treatments, and developing efficient models of care.[6][7]
• Eliminate inequities by adapting services for lower-income, rural, remote, underserviced and identity-specific populations, reducing jurisdictional barriers, and bringing appropriate care closer to home.[7][8]
• Provide integrated information, psychosocial support, rehabilitation, mental-health support, peer support, transport assistance and care coordination for people living with cancer, families and caregivers throughout the cancer journey.[9]
• Strengthen early palliative care and person-centred end-of-life care, including care in a patient’s preferred setting, and improve transitions and integrated support for children, adolescents and young adults.[10]
• Advance research, inclusive clinical trials, data use, digital health and appropriate artificial intelligence to improve prevention, diagnosis, treatment, care quality and service planning.[11][12]
• Advance First Nations-, Inuit- and Métis-specific priorities for culturally appropriate care closer to home, self-determined cancer programmes and services, and Peoples-governed research and data systems.[13][14][15][16]

Implementation

The Canadian Partnership Against Cancer is the Strategy’s steward and is responsible for working with cancer systems and partners to sustain improvements, accelerate action and report collective progress between 2019 and 2029. Implementation uses pan-Canadian networks to share expertise, align common measures, transfer effective practices and address challenges that individual organisations or jurisdictions cannot resolve alone.[1][17][18][19]

• Develop implementation plans with provincial and territorial cancer agencies, governments, ministries of health, public-health bodies, primary-care organisations, health professionals, researchers, charities, patient groups, people living with cancer, families and caregivers.[1][3][10]
• Coordinate cancer services across provincial, territorial and federal jurisdictions, including specialist support, highly specialised treatment pathways and participation in clinical trials across borders, using technology, funding arrangements and other enablers where needed.[8][9]
• Expand virtual care, electronic referrals, rapid diagnosis clinics, mobile testing, patient portals, accessible electronic medical records and patient-facing digital tools to improve communication, access and coordination, especially in rural and remote communities.[5][12][20]
• Integrate primary, specialist and community care through shared care plans, multidisciplinary teams, patient navigation, community partnerships and new care models, including family physicians specialising in cancer care.[6][7][9]
• Review drugs, tests and treatments for value, involve patients and the public in assessing care, and redirect resources from low-value practices towards proven innovations and high-benefit interventions.[7]
• Strengthen research infrastructure, clinician-researcher collaboration, trial enrolment and participant diversity, while mobilising national and international partnerships through alignment with the Canadian Cancer Research Alliance.[11]
• Improve health-data access, linkage, interoperability, collection and reporting so that providers can assess practice against benchmarks and administrators can improve planning and services.[12]
• Work through distinctions-based engagement with First Nations, Inuit and Métis governments, organisations, communities, Elders, knowledge holders and care providers to develop self-determined, culturally responsive programmes and data governance.[20][13][16]
• Build culturally safe care by addressing racism and prejudice, training providers, supporting traditional and wholistic approaches where appropriate, improving navigation and interpretation, and reducing travel and access burdens.[8][14][15]
• Measure progress through shared indicators and targets, data-collection capacity, patient-reported outcomes and experience measures, and regular public reporting, including annual updates on collective progress. First Nations, Inuit and Métis data and reporting are intended to follow relevant Peoples-specific governance principles.[9][10][14][15][2]

Monitoring & Evaluation

The Strategy combines outcome monitoring, data-system development, public reporting and Partnership stewardship to demonstrate measurable progress between 2019 and 2029. The Canadian Partnership Against Cancer is accountable for monitoring and reporting collective results, including annual updates to Canadians against shared indicators and targets.[19][2]

• Measure population outcomes through cancer incidence, survival and mortality, with reported changes including reduced incidence for several cancers and lower breast and prostate cancer mortality.[21]
• Develop meaningful impact measures, data-collection capacity and common performance measures to support data-informed decisions and assess the Strategy's impact over 2019 to 2029.[19][2]
• Report regularly to Canadians on implementation progress and collective results.[22][23][2]
• Monitor diagnostic pathways by collecting data on gaps between first presentation with symptoms and confirmed diagnosis, and by assessing diagnostic access and delays. Colonoscopy waits following abnormal colorectal screening results reportedly range from 37 to 88 days across Canada.[4][5]
• Measure and report the results of adopting cancer-care standards, clinical guidelines and practice improvements, using benchmarks and standards to support provider practice review and service improvement.[6][12]
• Strengthen information systems and performance-measurement capacity across institutions and jurisdictions to monitor cancer burden, evaluate best practices, coordinate action and support service planning.[9]
• Collect patient-reported outcomes and patient-experience measures in clinical and community settings to inform person-centred care, including quality-of-life considerations and the broader economic and societal effects of cancer on patients and caregivers.[10]
• Use linked diagnostic, assessment, treatment, medication and outcome data, alongside advanced analytics and appropriate artificial intelligence, to determine which interventions work for particular patients and circumstances.[20]
• Support research and surveillance through a database containing health and lifestyle information from more than 300,000 Canadians, standardised data on cancer spread, and real-time patient-symptom data.[21]
• Strengthen tobacco-related science, surveillance and partnerships, while maintaining attention to the effects of vaping and cannabis smoking.[3]
• Establish Peoples-specific data, indicators, targets and reporting arrangements for First Nations, Inuit and Métis Peoples. First Nations actions include governance of data collection and use, First Nations-determined indicators and outcomes, and research conducted according to First Nations principles and ethical processes, including Ownership, Control, Access and Possession.[17][14]
• Develop Inuit-specific reporting through a report card that includes measures such as time to diagnosis and travel time, enabling tracking of progress, trends and disparities in care.[15]
• Collect Métis-specific data in safe spaces for self-identification and use Métis-determined indicators and outcomes, while respecting applicable First Nations, Inuit and Métis information-governance principles in data collection, information systems and data sharing.[16][2]
• Investigate environmental contamination as a potential influence on Inuit health, cancer risk and food supplies.[15]

The source establishes broad commitments to measurable change, common measures, annual public updates and Peoples-governed data systems, but does not specify a complete consolidated indicator catalogue, indicator definitions, quantitative targets for every priority, independent evaluation design, surveillance protocol or universal reporting timetable.[22][12][2]

Costing & Financing

The Strategy recognises financial sustainability as a major cancer-system concern, but the supplied material provides no dedicated Strategy budget, financing envelope, quantified allocation, funding-gap estimate or detailed economic assumptions.[24][16][2]Health Canada funded the Strategy's implementation and stewardship by the Canadian Partnership Against Cancer, although the amount and continuing funding arrangements are not specified.[18]

• Recognise concern among consultees about the cost of cancer care, the sustainability of the health-care system, and the continuing need for stewardship and implementation resources.[1][22]
• Address financial pressure from increasingly complex treatments, including chemotherapy and radiation therapy, whose costs reportedly tripled in less than a decade.[24]
• Balance quality and sustainability by reducing low-benefit drugs, tests and treatments, redirecting resources towards proven innovations and high-value care, and adopting efficient care models.[6][7]
• Use collaborative procurement of technologies as a potential route to cost savings, without a specified monetary estimate.[12]
• Consider digital and virtual-care technology, specialist-care reliance and health-workforce shortages as operational and financial sustainability pressures, particularly in areas where specialist-delivered models may be difficult to sustain.[24][6]
• Mobilise resources and infrastructure for cancer research through alignment with the Canadian Cancer Research Alliance and national and international partnerships.[11]
• Use funding arrangements and other enablers to support cross-jurisdictional specialist care, nationally available specialised treatment pathways and participation in clinical trials across borders.[8][9]
• Invest in First Nations, Inuit and Métis community programmes, health-care capacity, navigation, research capacity, data systems and self-determined service delivery.[14][15][16]
• Provide equitable resources to reduce financial burdens associated with travel, access to care and basic health supports, and seek sufficient and sustainable funding for relationships between the cancer system and Métis governments and communities.[14][15][16]
• Record estimated economic benefits over a stated ten-year period of 5.2 billion dollars in avoided treatment costs and more than 20 billion dollars in avoided productivity losses from cancer deaths, alongside estimated cancer-treatment expenditure of 50 billion dollars.[21]

Although the material identifies investment needs and system-level cost pressures, it does not allocate resources by priority, establish a resource-mobilisation plan, quantify the cost of implementation, or identify a funding shortfall.[11][20][16]