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More Nova Scotians Surviving Cancer

PromisinRon Dewarg news for Nova Scotians! Today, more Canadians than ever before are surviving a diagnosis of cancer. This information was recently published by Statistics Canada in a national level update, based on people who were living with cancer from 2004 to 2006. While the national level picture is informative, it is important for Nova Scotians to understand cancer survival at a provincial level and know how we are doing compared to the country as a whole. Ron Dewar, a Senior Epidemiologist with Cancer Care Nova Scotia, has compared the national figures to Nova Scotia data for the most common cancers.

“The picture is very similar – and encouraging in many respects,” he says. Nationally, the five-year relative survival figure for this time period is estimated at 62 per cent. In Nova Scotia the situation is very similar at 61 per cent.

What does Relative Survival Ratio mean?
Relative survival represents the probability that a group of cancer patients will survive their cancer, after considering the chances of dying from all other causes. It is usually described and presented as a ratio, because that is how it is computed.

“We recognize that cancer is not one disease, but starting with an overall statistic like this enables us to compare how well we are doing generally over time and provides an easy comparison across Canada,” says Ron. “We can learn from each other.”

The analysis also looks at survival for several specific types of cancer. For breast cancer, the ratio is 87 per cent in Nova Scotia (88 per cent nationally), and for prostate cancer this rises to 99 per cent here and 96 per cent across Canada. The ratios for colorectal cancer are 65 per cent and 63 per cent, respectively, and for lung cancer, 15 per cent and 16 per cent.

Current Nova Scotia survival estimates have generally improved over those from 1992-1994 (the period chosen for the national comparison), in line with the national data. Among all cancer patients diagnosed in this earlier period, the five-year relative survival ratio was 54 per cent, compared with 61 per cent in the most recent period. This improvement, over time, is a very concrete reflection of improvements in early detection, treatment and care.

“This information is important from a health system point of view,” notes Ron. “It lets us see how we are doing compared to other areas and it helps us understand where improvements are needed. It is an important part of the cancer surveillance toolkit.”

The statistics also raise important questions about what is helping to improve survival over time. While there is no definitive answer, and advances depend on the type of cancer, there are several important contributing factors.

Screening is expected to have an impact on survival for many cancers. The Statistics Canada report notes that survival from cancer depends on the type of cancer and the age at diagnosis. More importantly, early detection of cancer improves long-term prognosis. Screening for cancers of the breast, cervix and colon and rectum often detect cancer in its earlier stages.

This is the impetus behind CCNS’s Colon Cancer Prevention Program, which was designed to detect cancer and pre-cancerous growths in Nova Scotians aged 50-74. While it is too early to assess the impact of this initiative, colon cancer is both preventable and treatable if found early.

CCNS has also worked closely with health professionals to standardize surgical aspects of treatment and develop care and treatment guidelines, based on the most current evidence available. For example, there are now guidelines for cancer of the kidney, testicular cancer in adults, head and neck cancers, lung cancer, and prostate cancer.

Dr. Carman Giacomantonio, Chief Medical Director for Cancer Care Nova Scotia, says the organization’s mandate is to ensure a uniform standard of care is provided to all Nova Scotians who are diagnosed with cancer.

Cancer Care Nova Scotia will continue to work with  with health professionals throughout the province to develop the clinical standards, programs and tools that support improved patient outcomes,” he says. “Data collection and analysis enhances our understanding of cancer behaviour and treatment outcomes for Nova Scotians and is essential to informing decision making around best practices and assessing the effectiveness of our cancer programs.”

Moving forward, Cancer Care Nova Scotia will gain an even greater understanding of the Nova Scotia cancer experience and be better positioned to explain survival ratios for Nova Scotians as compared with all Canadians.

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