Wait Times for Cancer Treatment Better than Provincial Average

Local cancer patients get shorter wait times for surgery, radiation treatment and chemotherapy, according to a province-wide report on the quality of cancer care released Tuesday.

The 2014 Cancer System Quality Index confirms significant improvements in cancer treatment in the Erie St. Clair health region, but it also points to glaring problems when it comes to cancer rates.

Our survival rates for all four cancers examined — lung, prostate, breast and colon — are lower than the provincial average, and our incidence rate for prostate cancer leads the province, with lung and breast cancer above the average.

To bring these numbers down, it’s largely up to the people to take care of themselves and get screened, says Neelu Sehgal, the manager of prevention and screening for the Windsor Regional Hospital Cancer Program, who cited this region’s poorer-than-average incidence of obesity, poor eating, lack of exercise and smoking (though the smoking rate recently dropped significantly). We also are below Ontario’s average when it comes to two of the three recognized cancer screening programs — colorectal and cervical.

“Forty per cent of cancers can be prevented by addressing those modifiable risk factors,” said Sehgal.

She said the community can “absolutely” bring the cancer rates down. “We can become more active, we can quit smoking, we can ensure we’re eating our minimum five fruits and vegetables a day.”

Another reason the local rate is higher is 39 per cent of the population is over 50, compared to 36 per cent provincially. Age is a cancer risk factor that people can’t control, so as the population ages it becomes even more important to address the factors that can be controlled, said Marla Jackson, a health promotion specialist with the program.

“Certainly there are a lot of things within people’s control, including being screened to catch it early, that they can do to help prevent or reduce the impact of cancer in their lives.”

Cancer cases
The Erie St. Clair health region, which includes Windsor-Essex, Sarnia-Lambton and Essex-Kent, will have 4,045 new cancer cases in 2014, according to the Cancer System Quality Index.

There will be 1,656 cancer deaths, while there will be 73,532 new cases for all of Ontario and 26,760 deaths.

Cancer rates
The region has the highest prostate cancer rate in the province (157.7 per 100,000 population compared to 106.6 provincially), the lung cancer rate is significantly higher (58.4 compared to 48.6), and we have a higher rate for breast cancer (103.5 compared to 99.1).

Our colorectal cancer rate of 38.2 is lower than the provincial rate of 44, while the cervical cancer rate of 9.6 is slightly higher than the provincial rate of 9.4.

Survival rate
Cancer patients in this region have a lower survival rate in all four cancers outlined in the report.

The five-year survival rate for breast cancer is 83.6 per cent compared to 86.4 provincially. It’s 91.6 per cent compared to 94.8 per cent for prostate cancer, 62.4 per cent compared to 65.4 per cent for colorectal cancer and 16.6 per cent compared to 18.9 per cent for lung cancer.

For colorectal cancer screening, 27.6 per cent of people age 50 to 74 were screened in the previous two years, compared to 29.9 per cent provincially.

The percentage of women age 50 to 74 who had a mammogram within two years was actually higher at 63.2 than the provincial average of 60.3. However, the percentage of women age 20 to 69 who had at least one Pap test for cervical cancer screening in the last three years was 61.6 compared to 64.3 provincially.

Sehgal said recent improvements have been made to increase the number of people getting screened. Her team is using the successful breast screening program as a model for the colorectal and cervical cancer screening.

Screening not only helps discover cancer earlier so different treatment options are available and there’s a greater survival rate, said Jackson. For colorectal and cervical cancer, screening can find and remove pre-cancerous cells and actually prevent cancer.

Surgery wait times
The percentage of cancer patients who get surgery within the targeted time is 84.6 per cent, which is slightly higher than the provincial average.

The percentage of local women who get surgery for breast cancer within the targeted time is 87.6 per cent, compared to 86.9 provincially. For gynecological cancer cases, the local rate is 81.4 per cent, significantly better than the provincial rate of 73.7.

Radiation wait times
The percentage of local breast cancer patients who are seen for radiation treatment within 14 days after they are ready to be treated is an impressive 97.2 per cent compared to 92.2 per cent provincially.

Chemotherapy wait times
The percentage of local breast cancer patients treated within the targeted time of 28 days from consult to start of treatment is 83.8 per cent compared to 77.5 per cent provincially.

The percentage of patients who had surgery and then received chemotherapy within 120 days of their diagnosis was 87.7 per cent (compared to 77.6 per cent provincially) for breast cancer patients, and 85 per cent (compared to 83.9 per cent provincially) for colon cancer patients. And 75 per cent of colon cancer patients received the surgery within 60 days of surgery compared to 55.7 per cent provincially.

Fewer local breast cancer patients receiving chemotherapy ended up in hospital for acute care treatment of such problems as infection or fever (17.3 per cent compared to 20.7 per cent provincially).

Patient satisfaction
When it comes to outpatient cancer care, 61.2 per cent of local patients expressed satisfaction with the information, education and information they received, compared to 58.6 per cent provincially.

Eighty-four per cent of patients said that their healthcare team responded to their feelings of anxiety or depression, compared to 83 per cent provincially.

And 90 per cent of local patients said their pain was controlled to a comfortable level.

Making improvements
Jeff Booth, director of the regional cancer program, said a lot of work has gone into getting the wait times down for chemotherapy, radiation treatment and surgery.

A third radiation machine was brought in in 2010 which resulted in a dramatic improvement in wait times, he said. For chemotherapy there were huge improvements to the system, including organizing oncologists, nurses and clerks into clinical teams, that helped streamline operations and move patients more quickly through the system. And the surgical program at the hospital was also revamped to provide more timely and accurate data, allowing the operating room to react quickly, said Booth.

He said the real attention should now be placed on improving the modifiable risk factors. “If we can get to the prevention and screening portion of that, I think we could really help out and make a difference in society.” Booth said.


[Source: The Windsor Star]