thecancercollaborative
lecollaboratoirecancer
Cancer is the leading cause of death in Canada, responsible for 28.2% of all deaths12 with previous estimates showing that 43% of all people in Canada are expected to receive a cancer diagnosis in their lifetime.13 This translates to nearly 2 in 5 Canadians being diagnosed with cancer, and 1 in 4 dying from the disease.13 The number of new cancer cases and deaths in Canada is also increasing. According to the latest report by the Canadian Cancer Society (CCS), it is estimated that in 2022, more than 230.000 Canadians will be diagnosed and 85.000 will die from the disease.13,14 And according to data released by CCS, at the beginning of 2018, over 1.5 million Canadians were living with and beyond cancer, representing almost 1.7 million cancer cases that had been diagnosed in people still alive up to 25 years after their cancer diagnosis.15
In 2020 alone, 275.000 Canadians were estimated to receive a new cancer diagnosis (this number excludes Québec) and 83.300 to die from the disease.16 In 2021, new cancer diagnosis saw a decline to over 229.000 and mortality down to 84.600. In 2022, 233.900 Canadians are expected to have received a cancer diagnosis with an estimated 85.100 cancer related deaths.
In Canada, incidence will jump from 274.000 in 2020 to 401.000 by 2040. And mortality will increase from 86.700 deaths to 141.000 in the same time frame. Worldwide, the number of people who will receive a new cancer diagnosis in 2040 will jump to 30.2 million people.
In addition to its impact on health, cancer is costly. The economic burden of cancer care in Canada rose from 2.9 billion in 2005 to 7.5 billion in 2012, mostly owing to the increase in costs of hospital based care. From a societal perspective, cancer related costs were 26.2 billion in 2021 with 30% of costs borne directly by patients and their families. Economic burden is highest in the first year of care after diagnosis. During this time, costs amounted to almost 4.8 billion in 2021.17
Since 2020, the COVID19 pandemic has infected over 4.5M Canadians and has killed nearly 50.000 people across the country. During this same period, an estimated 253.000 Canadians have died of cancer related deaths. These statements are not meant to diminish the horrific impact that COVID19 has had globally, but rather to reinforce the significant advances that were made in a short amount of time.
The COVID19 pandemic and the experience with vaccine development have clearly shown us that when we come together, when we pool our efforts and resources, it is possible to make unprecedented progress. A coordinated global effort to end the COVID19 pandemic led to lifesaving vaccines in less than two years.
A google search for COVID19 will bring up databases from across the globe that can provide real time information on the number of new cases and deaths. Today, after decades of investment into cancer research and care, no such site exists to provide comparable accurate information, provincially, nationally, or internationally. And in Québec, in 2023, no formal collection of cancer related data exists.
For over a decade, cancer has been the leading cause of death in Canada and yet unlike other jurisdictions, there is no national cancer strategy in place to reduce the burden of cancer on health systems and Canadians. We acknowledge the Canadian Partnership Against Cancer (CPAC), and its contribution to cancer control efforts since its inception. However, CPAC lacks the comprehensive approach and funding as well as the necessary political authority to implement policy changes. Falling short in comparison to other national strategies (EU Beat Cancer, US Moonshot Initiative)
CANCER ON US AND EU AGENDAS
Historically, cancer has received alarmingly little political attention, with limited visibility on national and international agendas. Since 2016, politicians in the United States (US) and the European Union (EU) have strengthened their responses to the growing burden of cancer, investing and prioritizing research, prevention, and treatment initiatives to improve outcomes for patients and reduce the incidence of cancer in their populations.
US CANCER MOONSHOT
The Cancer Moonshot initiative aims to accelerate scientific discovery in cancer, foster greater collaboration, and improve the sharing of cancer data. Launched in 2016 under President Barack Obama, the cancer moonshot was initially funded through the 21st Century Cures Act with 1.8B$ to fund the initiative over 7 years for cancer research in many areas including studies on cancer disparities, new clinical trial networks to drive drug discovery, and innovative projects examining childhood cancer. The initiative also sought to bring together researchers, healthcare professionals, patient advocates, and other stakeholders to collaborate and advance the understanding and treatment of cancer.
The new law streamlined cancer related decision making at the FDA through the formation of an oncology centre of excellence, so that effective treatments can be approved faster, and patients can have more direct access to information about the regulatory process.
In 2022, an additional 195M$ of funding was announced to reignite the Cancer Moonshot initiative, highlighting new goals: to cut today’s age adjusted death rate from cancer by at least 50 percent within 25 years and to improve the experience of people and their families living with and surviving cancer.
The Biden Harris administration is working to mobilize an entire government, reestablishing leadership with a White House cancer moonshot coordinator, and the formation of a cancer cabinet, convened by the White House and bringing together departments and agencies across government to address cancer on multiple fronts.18
The Cancer Moonshot Initiative has also established several partnerships and collaborations to facilitate knowledge sharing and promote progress in the fight against cancer. This includes partnerships with pharmaceutical companies, academic institutions, and patient advocacy organizations, as well as international collaborations to share best practices and advance cancer research on a global scale.19
EU BEAT CANCER
Europe recognized the urgent need for a renewed commitment to cancer prevention, treatment and care that recognized the growing challenges, and opportunities to overcome them. The Beat Cancer Plan, launched in February 2021, was built to respond to the need for; a whole of government approach that focuses on the patient and maximizes the potential of new technologies and insights; strengthens cooperation and opportunities for EU added value; eradicates inequalities in access to cancer knowledge, prevention, diagnosis and care; and delivers improved health outcomes to patients. It reflects a political commitment to leave no stone unturned to take action against cancer.
4€ Billion has been earmarked for the Beat Cancer Plan, which is structured around four key action areas with the most value: (1) prevention; (2) early detection; (3) diagnosis and treatment; and (4) quality of life of cancer patients and survivors. It also has policy objectives built into the plan to enable member states to share resources and expertise, allowing patients across the EU access to better care.
The Beat Cancer Plan, like the US Cancer Moonshot, recognizes the value of partnerships and is based on a ‘Health in All Policies’ multi stakeholder approach and is the result of an extensive consultation process. But most importantly, Europe’s Beating Cancer Plan places the interests and wellbeing of patients, their families, and the wider population at the centre of their actions.19
In May 2017, health leaders from world governments made a commitment to further invest in cancer control as a public health priority, passing the World Health Assembly Resolution 70.12, CANCER PREVENTION AND CONTROL IN THE CONTEXT OF AN INTEGRATED APPROACH 20 at the 70th World Health Assembly (WHA) in Geneva. The resolution provides a framework for countries to take action on cancer by identifying policy opportunities to scale up access to prevention, diagnosis, treatment, and care services.
The resolution identifies 22 priority actions, grouped into four key areas; data; early detection; timely and accurate treatment; and supportive and palliative care. The WHO calls on governments to embed these priorities into national cancer control plans that can drive the introduction or scale up of services, in line with national priorities and serve as an important platform to coordinate national stakeholders around common goals.