This issue of Current Oncology carries the first in a new series of Cancer System Indicator Snapshots that will appear regularly in these pages over the next several issues. This work is a product of the Canadian Partnership Against Cancer, which was funded by Health Canada, beginning in 2007, as an independent organization charged with the mission of accelerating action on cancer control for all Canadians. And while the Partnership is a recognizable organization with staff, offices, and an address, it is first and foremost a partnership. Its work represents a synthesis of the contributions of a great many partners: individuals such as cancer experts, patients, and survivors; and organizations that include cancer agencies, governments and their departmental staff, research partners, and charitable organizations. The list of those working toward improvement in cancer control is a long one indeed, and it is to Canada’s benefit that this is true.
The goal of the Cancer System Indicator Snapshots is to present, in a brief and accessible format, a sampling of the results from the partners’ collective efforts to measure Canada’s current status in cancer control. Making such information widely available is key to identifying the most promising paths to rapid improvements that will benefit patients, their families, and the public. In support of this work, and to ensure broad engagement, workshops, network meetings and consultations have been held across the country to arrive at a common determination of key quality indicators for performance in the cancer control arena. The Partnership has also developed processes to collect valid and comparable data to use in assessments of progress and has convened a collaborative effort to report on those data with as much of a pan-Canadian reach as possible.
Canadians are privileged to have had, over the course of the past many years, an excellent foundation for understanding cancer control through its cancer registries, which compare favorably in quality with those around the world. However, some questions have not been able to be addressed from a pan-Canadian perspective. Some of those questions are being addressed through work funded by the Partnership and involving collaboration with the provincial cancer registries and Statistics Canada, home of the Central Canadian Cancer Registry, which will see uniform staging data on the four most common cancers (lung, breast, prostate, colorectal) in place for the 2010 coding year and beyond in almost all provinces. That uniformity will permit the data to be used to monitor the early impact of screening initiatives, and to compare survival rates across geographic and demographic groups, achieving an understanding, for example, of the relative potential roles of treatment variations or late diagnosis in the differences found. Those data, although not yet available for use, will soon help to provide more explanatory power concerning the differences currently seen in cancer mortality across the country.
Nevertheless, even with excellent and augmented registry data, some questions were not able to be answered without a concerted effort to prioritize them and to develop specific plans to collect data that address them. As a result, the Partnership has closely collaborated with the provincial cancer agencies—and their equivalents in provinces without agencies—to take a look at a critical data gap that had not yet been addressed: the events that occur between diagnosis and death. One result of the associated work is the Partnership’s System Performance Initiative, which was inaugurated in 2009, and which has produced several reports that contain an unprecedented scope and breadth of indicators at the pan-Canadian level. (See http://www.cancerview.ca/systemperformancereport for the most recent report.) An example of one of the indicators is profiled in these pages (p. 175). Other reporting is taking place within various jurisdictions today (the work of Ontario’s Cancer System Quality Index being an excellent example), but the Partnership initiative provides, for the first time, an opportunity to understand and to learn from variations in practice patterns that may occur across the country. Future Snapshots will look at other indicators, some from the systems performance reports, and others from work carried out with national screening networks and other partners.
It is our hope that, by presenting some of this information to you, the cancer treatment community of Canada, a starting point for discussion within your own contexts will be generated. The Partnership plans to continue to work with you and your colleagues to develop an ever more robust description of our shared work in cancer control. It also hoped to put some tools directly into your hands—all of the information presented in these pages will be accessible through public access slides (http://www.cancerview.ca/publicuseslides), and the full-source documents will be available as well.
I invite you to contact the Partnership (heather.bryant@partnershipagainstcancer.ca) to provide feedback on the Snapshots, to suggest future topics, or to comment on any of these initiatives. Together, we hope to maximize the impact of the considerable efforts in cancer control in Canada, by using this new knowledge and by accelerating its integration into practice.