COVID-19 response

We are making sure the needs of Canadians affected by cancer are not forgotten during and long after the pandemic is over

The situation

This is an unprecedented time in our history – the COVID-19 health crisis is far-reaching and is having an undeniable impact on people across Canada and around the world. While the impacts of COVID-19 pandemic will be felt for months and years to come, so too will the needs of people with cancer and their caregivers change as the impacts of the pandemic evolve.

Living at the crossroads of COVID-19 and cancer: a report

Throughout the pandemic, we asked people affected by cancer how COVID-19 impacted their cancer experience. We’re pleased to share our new report, Living at the Crossroads of COVID-19 and Cancer, which presents themes of what we heard and guidance on how we can make cancer care better.

Collateral damage of COVID-19 pandemic

Because of cancer screening, surgeries and interventions essential to cancer care being postponed, the Canadian Cancer Society (CCS) is deeply concerned that we will see cancer cases diagnosed or treated too late.

This concern is rooted in worrisome trends in cancer care delays across the country. According to the Canadian Institute for Health Information, between April and September 2020 there was a 20% reduction in cancer surgeries compared to the same timeframe in 2019. A CCS-led survey in July 2020 of people with cancer and caregivers found that almost half (47%) of patients reported having their cancer care appointments cancelled or postponed. We know that when cancer is found and treated early, the changes of successful treatment are better. A Canadian and United Kingdom-led study published in the British Medical Journal shows that just a 4-week delay in cancer treatment increases the risk of death by about 10%.

Severity of the problem greatest in provinces hit hardest by the pandemic

Each province and territory have experienced and responded to the pandemic differently, requiring a unique response to address the concerns of people with cancer across regions. We know that all screening programs for breast, cervical and colorectal cancer across Canada were suspended in mid-March 2020. Screening programs started to resume at partial capacity in June 2020 with varying dates when they were able to return to full capacity. This screening program pause has created a backlog of screening tests including mammograms for early detection of breast cancer, stool tests for early detection of colorectal cancer and Pap tests for early detection of cervical cancer. Each positive screening test requires follow-up and additional diagnostics to determine if someone has cancer. Cancer treatments were also affected across all provinces. Most provinces saw a reduction in operating room availability, and elective surgeries were postponed. Oncologic surgeries were delayed at the discretion of treating physicians. Screening and surgical backlogs have cost and capacity implications for our healthcare system.

Underserved communities disproportionately affected

Pre-pandemic, lower rates of screening uptake are shown among underserved communities, including First Nations, Inuit, Métis, immigrants, visible minorities, people living with low-income and rural-remote populations. Inequities in screening uptake may potentially be exacerbated during the pandemic. Any screening resumption plans should include program activities to ensure equitable access and participation in cancer screening services.

What we are hearing from you

We continue to hear from people affected by cancer who say they are frustrated by a lack of access to their healthcare teams. Through our support programs, we hear from people with cancer who believe they are collateral damage of the COVID-19 pandemic. When we surveyed Canadians in early 2021, only 36% felt the federal government successfully cared for cancer patients during the COVID-19 pandemic, while only 38% believed their provincial government cared for cancer patients.

What we are doing to stand up for people affected by cancer

Cancer continues to be a matter of life and death during the COVID-19 pandemic. It isn’t waiting for the healthcare system to address backlogs, and it doesn’t stop being a life-changing and life-threatening disease during a global health pandemic.

As the voice for Canadians who care about cancer, we have brought this issue forward to all governments and called for immediate, urgent action to address the backlogs in cancer screening and care. We have made sure every government official we speak to understands that this is an issue of top priority that cannot afford to wait, because cancer will not wait.

You can help by making your voice heard. Join us by signing on to CCS Voices for Change, our volunteer group specifically for those wanting to be involved in our advocacy work and take action to change policies that will help the lives of those affected by cancer.

To learn more about what we’ve said to the federal government, read our submission to the Standing Committee on Health here.

Read our statement on COVID-19 vaccine prioritization for people with cancer here.

Recommendations for governments to ensure they prioritize people with cancer in their health care decision making for COVID-19

The immediate impact of COVID-19 on people with cancer is easy to understand, but the long-term effects will be equally devastating and action needs to be taken now to mitigate the impacts. The Canadian Cancer Society encourages all governments and health organizations to apply the following guiding principles to their health care decision making:

The safety of people with cancer, their caregivers, healthcare providers and staff working in the health system needs to be a priority.

Governments and health organizations must integrate perspectives of the public, people with cancer and their caregivers in their COVID-19 response.

Canadians must have equitable access to cancer screening, diagnostics and treatment regardless of where they live across the country or within a region.

Inequities across cancer care were likely exacerbated during the pandemic. Plans to resume cancer screening, diagnostics and treatment must address the unique needs of vulnerable and underserved communities that are disproportionately affected by cancer. These plans should also ensure equitable access and participation in services.
Data monitoring and research for COVID-19 must include a focus on how public health measures and health systems’ responses to the pandemic impact people living with cancer over time.
Public health measures and coping mechanisms for COVID-19 have impacted behaviours that increase cancer risk. Governments must ensure that chronic disease prevention programs and policies are not delayed due to the immediate responses to COVID-19.
Government, professional associations and healthcare organizations must raise awareness with Canadians that healthcare settings are safe and that participation in regular screening and appointments with doctors to discuss changes in health should not be delayed.
Organized screening programs for breast, cervical and colorectal cancers must resume at full capacity. All efforts must be made to avoid pausing their delivery again.
Rapid access to diagnostics for those suspected of having cancer must be prioritized.
Innovative solutions must be adopted to address the clinical backlog and reduce wait times, especially for postponed cancer screenings and delayed cancer surgeries.
All Canadians must have equitable access to the cancer drugs they require without financial hardship, regardless of where they live and where the drugs are taken. This requires ensuring that take-home cancer drugs are covered in every region and that drug shortages are addressed.
All people with cancer must have access to high-quality, person-centered palliative care and end-of-life care regardless of their age or where they live.
Caregivers are an essential part of healthcare team. Policies must be established to support the engagement of people with cancer and their caregivers in the care process.
Equitable access to transportation and accommodations to help people get to and from cancer appointments must be enhanced as part of the health system.
Health systems must continuously assess how they provide virtual care, understanding the benefits, risks and optimal implementation to ensure positive patient outcomes.

Provinces and territories need to take steps to reduce the impact of future waves of COVID-19 for all Canadians, but especially people living with cancer who rely on our health care system.

Consideration must be given to the timing of the vaccines for people with cancer. Healthcare providers should have the ability to provide COVID-19 vaccines outside of the vaccination schedule and be empowered to determine if their patient will benefit from an additional dose, and the timing of the dose, based on their unique circumstances including cancer type and treatment

Vaccination of healthcare workers should be made mandatory across all public and private settings.

Strategies should be implemented that decrease barriers to accessing vaccines including those faced by underserved and racialized communities.

People with cancer should be prioritized to receive the second dose of the COVID-19 vaccine before the general population