More people in Canada are living with cancer than ever before, suggesting the country’s already strained health care system will need to accommodate larger numbers of patients with long-term illnesses.
A report published Tuesday by the Canadian Cancer Society, in collaboration with the Public Health Agency of Canada and Statistics Canada, shows that in 2018, the latest year data were available, there were more than 1.5 million people living in Canada who had been diagnosed with cancer in the previous 25 years – about one out of every 25 people in the country at the time. The number includes both people who were undergoing treatment, and those who were diagnosed and recovered.
That is a substantial increase from 10 years ago, when the total number of people living in Canada after cancer diagnoses was only one million, or one in 34.
That so many more Canadians are living with cancer is explained partly by the fact that the country’s population is getting larger, and aging. And it also has to do with advances in treatment, which are improving outcomes and keeping more people alive than in the past.
But the report’s findings add to existing concern about the ability of the country’s health care system to provide high-quality, timely cancer care in the midst of the COVID-19 pandemic. A September report from the Canadian Cancer Society found that a high number of cancer patients had experienced significant disruptions in their care, including barriers to accessing screening, delayed diagnoses and postponed or cancelled treatment.
“There have been significant delays and interruptions to care for many individuals,” said Jennifer Gillis, senior manager of surveillance at the cancer society. “These can lead to later stage diagnoses, which we know often have lower survival.”
More investment is needed to make sure people living with cancer get the care they need and can enjoy their lives, she said.
“It does emphasize our need to continue to invest in research in areas where we can try and find those improvements in effective treatments and earlier diagnoses.”
She added that the cancer society would like to see improved access to supports for cancer survivors, better long-term follow-up for people who underwent treatment, and better end-of-life care for people dying of the disease, among other things.
“It really does involve all levels of government,” she said.
The report suggests those supports will have to be tailored to the needs of people of different income levels and from different parts of the country, whose diagnoses and outcomes can vary significantly.
There are not enough data to determine how income levels in Canada impact long-term cancer survival rates, but the report’s authors found that the numbers of people living two and five years after being diagnosed with breast or prostate cancer were greater in higher income areas, suggesting those people may have easier access to early screening and treatment, which would improve their outcomes.
In lower income areas, the report’s authors found more people living with colorectal and lung cancer, and people in those areas were less likely to survive those diagnoses compared with people living in higher income areas, according to the report. This is likely owing to a number of factors, including lack of access to primary care and difficulty accessing cancer screening.
The report also found that many types of cancer were more prevalent in rural areas, compared with urban ones. This is likely related to the fact that rural areas tend to have older populations. The report suggests the disparity could also have to do with other risk factors, including smoking and excessive alcohol use, which are more common in those areas.
People living in rural areas often have difficulty accessing screening programs and typically face lengthy travel times to health care facilities, which the report notes can negatively impact cancer outcomes.
The report found that the forms of cancer that the largest numbers of people in Canada have recovered from, or are still living with, are breast cancer, prostate cancer and colorectal cancer. Those three account for nearly half of all prevalent cancers as of 2018, meaning they are diagnosed more frequently and have better long-term outcomes than other forms of the disease.
Lung and bronchus cancer are the most commonly diagnosed forms of the disease in Canada, but aren’t as common among living Canadians because the long-term prognosis is typically so poor.
The overall number of people being diagnosed with cancer in Canada is also on the rise. It went from about 193,000 people in 2012 to 233,900 in 2022, according to the report. The increase is largely attributable to the fact Canada’s population is getting older.