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Nova Scotia’s cancer system performs well compared to rest of Canada
July 12, 2016
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Nova Scotia’s cancer system performs well compared to rest of Canada

July 12, 2016 (Halifax, NS)
– The cancer system in Nova Scotia performs well compared to other Canadian provinces in areas including breast, cervical and colon cancer screening. Participation in the national school-based immunization program to protect against Human Papillomavirus (HPV) is also high; HPV causes 70% of cervical cancers, 92% of anal cancers, 63% of penile cancers and 89% of oral cavity and oropharyngeal cancers. Nova Scotia is one of seven provinces that have implemented a standardized approach to screening for distress in patients to identify those who need psychosocial supports to cope with their cancer.

The Canadian Partnership Against Cancer’s 2016 Cancer System Performance report found that Nova Scotia has among the highest rates of cervical cancer screening in the country, with 83.1% of women, aged 25-69, who reported having had at least one Pap test in a three year period. Nova Scotia is in the mid-range for breast screening with 67% of women, aged 50-69, who reported having a mammogram within the past two years. The province is also in the mid-range rates for colon cancer screening with 48% of Nova Scotians, aged 50-74, who reported having a fecal test in the past two years. Nova Scotia has the fourth highest uptake of the HPV immunization program, with 75% of Nova Scotia girls in Grade 7 completing the HPV series. The reporting year for these statistics is 2012, except HPV vaccination uptake, which is for the 2013/14 school year.

Nova Scotia has one of the shortest wait times for resolution of an abnormal breast cancer screen when a tissue biopsy is required and one of the lowest rates of intensive care unit use near the end of life, indicators that show a commitment to improving the experience of cancer patients.

Nova Scotians wait 147 days from the time they receive results of an abnormal colorectal screening test until they have a follow-up colonoscopy. The shortest wait across the country is 104 days, suggesting timely follow-up of an abnormal colorectal screening test result with a colonoscopy is a challenge throughout Canada.

“The Partnership’s Cancer System Performance Reports provides valuable insights, interprovincial comparisons and trends, enabling provinces to identify areas where we are doing well and areas for increased focus, “ said Dr. Drew Bethune, Medical Director, Program of Care for Cancer, Nova Scotia Health Authority. “We are reasonably pleased with the uptake in our screening programs, but we know we can do better –
particularly in encouraging more Nova Scotians to regularly complete the home screening kit for colon cancer.

“Work is already underway to address areas in the report where Nova Scotia does not rank as well as other parts of the country. Example include our work in developing clinical recommendations and standards for colorectal cancer, lung cancer, oral chemotherapy; and our participation in a Partnership project designed to integrate tobacco cessation and relapse prevention into cancer care. Nova Scotia’s participation in Exercise is Medicine and its Thrive! Strategy are designed to promote the value of healthy eating and physical activity – as one way of addressing our high obesity and low physical activity rates, both of which contribute to our high cancer rates and the prevalence of other chronic diseases.”

The report – the seventh in a series – found change involving multiple sectors in the healthcare system is still slow and requires more collaborative efforts across clinical settings. Since the Partnership began reporting on pan-Canadian cancer system data in 2009, there have been system-wide improvements, most notably more consistent pathology reporting, resulting in more accurate staging and better treatment plans for colon cancer patients.

The 2016 Cancer System Performance Report also shows:

* Lower-income cancer patients are less likely to survive the disease. For the first time, researchers were able to analyze cancer survival rates for breast, lung, colorectal and prostate cancers by income category, while removing the effect of other health risks. The difference in survival rates – an almost 10% difference in the case of colorectal cancer – suggests lower-income patients are not receiving equitable care. Lower-income individuals may face barriers to being screened for cancer, may not have symptoms recognized early or may not receive the most effective treatment.

* Generally, there is greater uptake of colorectal cancer screening, increasing clinical trial participation, wider collection of patient-reported information on physical and emotional symptoms, increasing rates of breast-conserving therapy and better concordance with colorectal cancer treatment guidelines. All of these improvements translate to better care and better outcomes for patients, as evidenced by decreasing rates of death for many cancers.

* There is still wide variability in the percentage of mastectomies performed as day surgeries and differing rates of HPV vaccination uptake, which indicates that there is more to be done to develop a pan-Canadian approach.

* While participation in colorectal cancer screening has improved in the relatively short time programs have been in place, it remains low while wait times for receiving colorectal cancer screening results remain high.

Quotes:
“Across Canada, there is a need to collect more cancer-related data, better leverage and link existing data holdings and strengthen analysis. This will help support and guide improvements to patient care and the sustainability of the cancer system,” said Dr. Heather Bryant, Vice President of Cancer Control at the Partnership.

About the Canadian Partnership Against Cancer
The Canadian Partnership Against Cancer works with Canada’s cancer community to reduce the burden of cancer on Canadians. Grounded in and informed by the experiences of those affected by cancer, the organization works with partners to support multi-jurisdictional uptake of evidence that will help to optimize cancer control planning and drive improvements in quality of practice across Canada. Through sustained effort and a focus on the cancer continuum, the organization supports the work of the collective cancer community in achieving long-term population outcomes: reduced incidence of cancer, less likelihood of Canadians dying from cancer, and an enhanced quality of life of those affected by cancer.

Media contact:

Christine Smith                                          Karen Palmer
Program of Care for Cancer                    Canadian Partnership Against Cancer
Nova Scotia Health Authority                   416-915-9222 x5844 (office)
902-222-9739                                            647-388-9647 (BB)
ccns.nshealth.ca        partnershipagainstcancer.ca