Excellent Care for All

Cancer Screening

Health Care Challenge

Cancer screening saves lives. If cancer can be detected and treated earlier it greatly increases the likelihood that patients will make a full recovery. For example, when caught early through screening there is a 90 per cent chance that people with colorectal cancer will be cured. Yet, it is the second deadliest cancer in Canada. Ontario has one of the highest rates in the world and more than 3,250 people in the province die from the disease each year.

The more Ontarians get screened for breast, colon and cervical cancers the greater their chances of survival. Also, they are less likely to require invasive procedures like complex surgery, radiation and chemotherapy.

Screening is the best line of defence. Early detection through screening puts less strain on patients and their families, and the system as a whole.

Real Change in Action

Ontario has been a leader in cancer screening in Canada.

It is important to continue increasing screening rates for breast, cervical and colorectal cancer. As part of this commitment, the OBSP was expanded in 2011 to include screening for women between 30 and 69 years old, who are at a high risk for developing breast cancer. Through the OBSP, these women can receive screening with an annual mammogram, plus a breast MRI. Research shows that having both types of screening is the best way to detect breast cancer in women who are at high risk. Previously the OBSP screened women 50 and older. The expansion has made cancer screening available to thousands of additional women in Ontario who are at high risk.

“Cancer screening rates have been moving in the right direction, but we are focused on doing more because of the evidence that early detection is so beneficial to outcomes,” said Dr. Linda Rabeneck, Vice President, Prevention and Cancer Control at Cancer Care Ontario (CCO).

Back in 2001-2002 about 60 per cent of women in Ontario were up-to-date with screening for breast cancer. By 2007-2008, this had increased to 66 per cent. But the current aim is to have 70 per cent of women aged 50-69 participating in regular breast screening and to increase this to 90 per cent by 2020.

In 2007-2008, 30 per cent of the targeted population – men and women, aged 50 to 74 – was screened for the disease using the fecal occult blood test (FOBT). Back in 2005-2006, 20 per cent of the target population was screened using the FOBT. This data does not include colonoscopy, which is advised for those at increased risk because of a family history of one or more first-degree relatives (parent, sibling or child) with a diagnosis of colorectal cancer.

ColonCancerCheck has involved a focused public education campaign and encouraged primary care providers to promote the use of FOBT kits to their patients. The aim is to increase the use of FOBT kits among the targeted population to screen for colon cancer.

To increase screening rates, CCO, the Ministry of Health and Long-Term Care and other partners, will more aggressively promote screening, particularly to reach under-screened populations, including new Canadians, people living in poverty and First Nations, Metis and Inuit people.

Online tools are also being made available to better inform Ontarians about their cancer risk and when they should get screened for various cancers.

Dr. Rabeneck explained that focusing on ensuring and improving the quality of cancer screening is as important as increasing screening rates. For example, women can get screened for breast cancer through the OBSP or at sites that are not part of the program. Dr. Rabeneck said CCO has a goal of having the majority of breast screening in Ontario done through OBSP because the program is tracked and continuously evaluated on evidence-based performance criteria. All OBSP sites are accredited with the Canadian Association of Radiologist Mammography Accreditation Program.

The OBSP is readily accessible and women with or without a family physician can book their own appointment to be screened and are reminded by letter when they are due for their next screen. OBSP sites help women with abnormal mammogram results move through the diagnostic phase to ensure timely, co-ordinated assessment. “It’s not enough to screen, we have to ensure there is the appropriate follow up, diagnostic tests and treatment,” Dr. Rabeneck said.

“We have to strive for the highest possible screening activity in the target age group for the three cancers – breast, cervical and colon,” she said. “We also must continue to support a high quality screening process and follow up to maximize the benefits of early detection.”

Better Quality, Sustainable Care

If pre-cancerous changes can be detected or cancer can be found at an early stage, the impact is profound on individual patients as well as the health system, Dr. Rabeneck said. “If you can detect it earlier the treatment is less arduous and the chances of good outcomes are greater.”

“If the 20 per cent of breast cancers that are diagnosed in stage 4 were discovered at earlier stages, it would mean shorter hospital stays and perhaps less need for chemotherapy and radiation,” Dr. Rabeneck explained.

“If you don’t detect colon cancer early, the centerpiece of the treatment is surgery. Early detection can mean no surgery or less extensive surgery.”

Cancer screening is better for patients and families and supports sustainability of the system by making the best use of health care resources.

Learn more about the Cancer Screening Program.

Contact person:

Marnie MacKinnon
Director, Prevention & Screening
Prevention & Cancer Control
Cancer Care Ontario

For More Information

Call ServiceOntario, Infoline at 1-866-532-3161
In Toronto, 416-314-5518
TTY 1-800-387-5559
In Toronto, TTY 416-327-4282
Hours of operation : 8:30am - 5:00pm