As federal NDP leader Jack Layton’s recent death reminds us, cancer represents a huge personal burden for Canadians, overtaking cardiovascular disease as the number one cause of death in this country.
“With an aging population, the number of people who are diagnosed and treated is increasing. This represents a significant challenge to our partners in the health system,” says Anne McFarlane, CIHI’s Vice President, Western Canada and Developmental Initiatives.
To date, CIHI hasn’t done a great deal of work in cancer analysis—but that’s changing.
For the past year and a half, a special team of CIHI analysts has been working to help further our understanding of cancer and its impact on the health system. This initiative is focused on identifying and using cancer data from all parts of our organization, acquiring data from the national cancer registry and improving methodologies to help people use the data more accurately and efficiently. We want to offer a pan-Canadian perspective on cancer services—something we are uniquely able to do given the participation of provinces and territories in our databases.
We’ve also been working with the Canadian Partnership Against Cancer (CPAC) on enhancing data, as well as developing analyses and indicators.
“We have to be efficient in the health care system,” McFarlane says. “CPAC has expertise in the areas of cancer control and prevention; we have expertise in database development and analysis. So we’ve agreed to help each other on certain projects to make the best use of skills and resources.”
The initiative has just released an analysis in brief: Surgery for Pancreatic and Esophageal Cancer in Canada: Hospital Experience and Care Centralization. Future analyses will include a study of lumpectomy versus mastectomy among breast cancer patients over time and geography. Next year, the focus turns to lung and colorectal cancer.
“We want to be a player in describing and analyzing services and care pathways for people with cancer,” McFarlane says. “We can call attention to how and where people have surgery, variations in care and outcomes, emergency visits for pain and how community services like home care are used. As our system struggles to provide high-quality, integrated care, we can help immediately with the data we have and be more helpful in the future as data and methodologies improve. ”
A major thrust on the data side is working with Statistics Canada to gain access to its Canadian Cancer Registry. The registry provides important additional information on cancer staging that is not available in CIHI’s current data holdings.
As well, it follows all cancer patients, so the registry captures data on someone diagnosed in Newfoundland and Labrador 10 years ago who died last year in Alberta.
Access to this data would allow us to improve our analyses and answer questions such as, “How sick was a patient at diagnosis, what services did he receive and how does that relate to his outcome?”
“It’s hugely exciting,” McFarlane says. “I think it’s really important to provide as much information as possible. People working in the system really try to provide great care. If we can help them, we should. We’ve got the technology, we’ve got the tools.”