Understanding cancer: CIHI explores the patient’s journey

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New data on wait times for cancer surgery. First year of data on cancer surgery wait times gives health care facilities and decision-makers a glimpse of how we are performing.

Cancer is the leading cause of death in Canada. Each day, 500 Canadians are diagnosed with cancer and 200 die from it, and the number of new cases is expected to increase as the population ages.

CIHI is working to help further Canada’s understanding of cancer and its impact on the health system. “We want to offer a pan-Canadian perspective on cancer services—something CIHI is in a unique position to do, given the active participation of provinces and territories in populating our databases,” says Anne McFarlane, Vice President, Western Canada and Developmental Initiatives. And, she adds, CIHI is ready and able to share this data with those responsible for improving care and services for cancer patients and their families.

New ideas, new focus

In 2011, CIHI put together a working group with a mandate to share information about cancer-related projects and initiatives across the organization. The group’s objectives are to ensure all areas of CIHI are aware of new data, methodologies and coding changes; encourage collaboration; and provide an opportunity to bring forward new ideas for potential work.

Now, 3 years later, the efforts of this group are paying off.

One significant development is the cementing of a formalized memorandum of understanding with the Canadian Partnership Against Cancer (CPAC). The MOU will support the development of key indicators and enhance CIHI’s understanding of issues related to cancer treatment and control.

CIHI is working with Statistics Canada and the cancer registrars to acquire data on diagnosis and staging from the Canadian Cancer Registry.

The number of CIHI reports on cancer-related data has increased steadily over the past few years. Some notable reports include Breast Cancer Surgery in Canada (produced in partnership with CPAC) and End-of-Life Hospital Care for Cancer Patients.

The scope of our cancer reporting has also increased. CIHI’s report Benchmarking Canada’s Health System: International Comparisons, released in November 2013, includes, for the first time ever, provincial data on cancer screening, survival and mortality rates.

Our March 2014 report on surgical wait times contains data on how long Canadians wait for 5 different types of cancer surgery: breast, prostate, colorectal, lung and bladder. This is the first time that this type of cancer data has been included in a CIHI wait time report. The report contains the encouraging news that 97% of cancer patients across Canada who required radiation therapy received it within the medically acceptable time frame of 28 days.

Outcomes outside of the system

The common thread running through all of this work is that it is focused on outcomes. “The data we’re collecting aims to provide valuable information on the patient’s journey,” says McFarlane. “We’re looking at episodes of care, and even beyond, to provide perspective on health outcomes outside of the typical system focus.” This approach, she explains, will allow care and service providers to use data to answer questions such as “How sick was a patient at diagnosis, what services did he receive and how does that relate to his outcome?”

On the horizon

So what’s next for CIHI and cancer data?

The cancer working group is embarking on an expanded program of work that involves widening and diversifying its scope of activities. These activities include pursuing new data holding opportunities, publishing more cancer-related articles in peer-reviewed journals, monitoring wait times for radiation and chemotherapy treatments, leading the development of new indicators, exploring patient satisfaction during care interactions, ramping up an oncology drugs initiative and continuing work on a prostate treatment study.

“It’s very exciting to be a part of this growing body of work,” McFarlane says. “People working in the system are committed to providing great care, and we feel that enhancing our working group’s activities will help ensure that CIHI is well-positioned to support those people.”