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cancer in canada: stats, resources and support
12 minute read
cancer awareness is often recognized by the rainbow of ribbons that represents each different form of the disease.
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what is cancer?
cancer is a disease that happens when our cells divide uncontrollably, growing into and damaging tissues and organs. it’s caused by changes or damage to dna, so genes inside our cells mutate and don’t work properly. a cancer cell doesn’t act like a normal cell that should grow and divide to make more cells only when your body needs them to replace aging or damaged cells. basically, a cancer cell keeps growing and dividing instead of dying when it should.
although there are many different types of cancer, this is how they all start, and it can happen in any cell in your body, according to the canadian cancer society. as cancer cells divide, tumours can develop.
general signs and symptoms linked to cancer include:
- fatigue
- lump or area of thickening that can be felt under the skin
- weight changes like unintended loss or gain
- changes in bowel or bladder habits
- skin changes like yellowing, darkening or redness of the skin
- persistent cough or trouble breathing
- unexplained bleeding or bruising
- persistent unexplained muscle or joint pain, fevers or night sweats.
so, is cancer just bad luck? you can be born with a genetic mutation that you inherited from your parents. this type of mutation, though, accounts for only a small percentage of cancers.
most gene mutations occur after you’re born, caused by other factors like smoking, alcohol, obesity, radiation, viruses, exposure to chemicals, chronic inflammation and a lack of exercise, notes the mayo clinic.
in fact, gene mutations happen frequently during normal cell growth. cells contain a mechanism that recognizes the mistake and repairs it. but cell division is an imperfect process and sometimes a mistake is missed, which can cause a cell to become cancerous. for this reason, it’s unlikely that cancer could ever be completely eradicated.
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as many experts agree, prevention is the way forward.
in canada, the number of new cancer cases and deaths each year is rising steadily because the population is growing and aging. cancer can develop at any age, but it is primarily a disease of aging. with our longer lifespans, we’re experiencing more cancer. nine out of 10 cancer cases in canada are diagnosed in people older than 50.
“a third of all cancers are preventable, which is heartbreaking,” says dr. lucy gilbert, oncology expert and gynecological cancer researcher at mcgill health sciences centre in montreal, que. “when you talk about both men and women, the top causes of cancer in canadians really are smoking, alcohol – it truly is a carcinogen – and obesity.”
while adopting healthy lifestyle habits isn’t always simple when people struggle with addiction or face socio-economic barriers, she stresses that these cancer-prevention behaviours are necessary and within reach.
for example, bc cancer’s senior scientist rachel murphy is campaigning for healthy food habits, citing certain cancers that have particularly strong links to diet. “the risk of developing breast cancer may be higher among women who consume more saturated fat in their diet. fiber is important to our gut health, and there is strong evidence that low-fiber diets increase the risk of colorectal cancer,” says murphy, who leads the organization’s ongoing precision nutrition study.
a recent u.k. study in the journal jama oncology found that as little as one or two minutes of vigorous exercise a day, whether it’s power walking, climbing stairs or strenuous housework could lower your cancer risk. formerly inactive adults who incorporated about four-and-a-half minutes of vigorous activity in short one- or two-minute bouts had more than 30 per cent lower incidence rates of cancer, the study found.
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as gilbert points out, women’s cancers are even more preventable. “both uterine cancer, which is the fourth most common cancer in canadian women, and cervical cancer are largely preventable.” aging and obesity are key risk factors for uterine cancer, which is now rising in incidence for younger women.
for cervical cancer, the human papillomavirus (hpv) vaccine through school-based programs and catch-up programs in all provinces and territories has been highly effective. a 2019 study published in the journal of infectious diseases by cancer researchers in british columbia found that the province’s school-based hpv immunization program, introduced in 2008, cut cervical pre-cancer rates by more than half. if not treated, pre-cancer can develop into cervical cancer. women who had received the hpv vaccine as grade 6 girls had a 57 per cent reduction in the incidence of cervical pre-cancer cells compared to unvaccinated women.
however, among women, cervical cancer is now the fastest increasing cancer – 3.7 per cent per year since 2015 – marking the first significant increase in cervical cancer incidence since 1984, says the canadian cancer society, the largest national charitable funder of research into all types of cancer. again, this speaks to the need for prevention education and awareness of hpv vaccinations and screening. the uptake of hpv vaccinations, hpv primary screening and better follow-up of abnormal results are a key focus of the canadian partnership against cancer, an agency founded by the federal government in 2007 to move the canadian strategy for cancer control into action.
cancer stats in canada
where are we at with cancer in canada? keep in mind that one in four of us are expected to die from cancer. and two in five of us will likely be diagnosed with cancer at some point in our lives. cancer is the leading cause of death, accounting for 29 per cent of all deaths, reports the canadian cancer society.
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sobering numbers, but there’s a lot to be hopeful about in the recent canadian cancer statistics 2023 report by the canadian cancer statistics advisory committee in collaboration with the canadian cancer society, statistics canada and the public health agency of canada. canada has progressed on many fronts, including prevention, early detection and treatment, but there’s clearly more to do.
as the statistics report outlines:
- since the cancer death rate peaked in 1988, it has decreased almost 32 per cent overall (39 per cent in males and 26 per cent in females).
- in 2023, an estimated 239,100 canadians are expected to be diagnosed with cancer and 86,700 are expected to die of the disease.
- in 2023, approximately 27 people will be diagnosed with cancer and nearly 10 will die of cancer every hour of every day.
- over 1,000 children, ages 0 to 14, are expected to be diagnosed with cancer this year (1,050).
- the rate of new cancer cases increases substantially with age. it is expected that 93 per cent of new cancer cases in males and 87 per cent in females will be diagnosed in canadians 50 years of age and older.
there are more than 100 different types of cancer, but these four – lung, breast, colorectal and prostate – account for almost half of all new cancer cases diagnosed in canada in 2023. the report highlights the fact that the lung cancer mortality rate is declining at the fastest rate reported to date and is declining faster than any other cancer type reported.
that’s promising, given that lung cancer is the most commonly diagnosed cancer in canada with 31,000 new cases expected in 2023, and the leading cause of death from cancer for both men and women. lung cancer starts in the cells of the lung but can spread to other parts of the body. smoking tobacco is the main risk factor, but about 20 per cent of people who don’t smoke can also develop the disease from risk factors like exposure to second-hand smoke, radon, asbestos, and chemicals on the job like welding fumes, bitumen used in roofing and diesel engine exhaust.
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the report notes that almost 93 per cent of lung cancer deaths will likely strike canadians 60 years of age and older. and approximately half of all lung cancer deaths are expected in the age range proposed for lung cancer screening in canada. screening is recommended for people aged 55 to 74 who currently or used to heavily smoke tobacco.
survival has increased and is higher on average for people diagnosed at earlier stages. the five-year survival is estimated to be 62 per cent for stage 1 but only 16 per cent for stage 3 and three per cent for stage 4. in many cases, lung cancer progresses over several years, so there are opportunities for clinical intervention.
while there have been tremendous medical advances in imaging and less invasive surgery, the problem is that people with lung cancer continue to present at later stages.
dr. christian finley, thoracic surgeon and professor at mcmaster university in hamilton, ont. and a member of the canadian cancer society’s statistics advisory committee, says that the stigma about the disease because of its connection to smoking is a huge issue. people often avoid seeing a healthcare professional about their early symptoms.
“we’ve educated children and adults about the dangers of smoking and that has led to a decline in rates, but at the same time, when i meet a new person in a clinic, usually the first thing they’ll say is, ‘you know i did this to myself.’ so that amount of self-blame is very sad to me. it is an addiction. half the population did smoke in the 1960s. it’s the same with obesity and other diseases that people judge unfairly,” he says. the 2022 canadian tobacco and nicotine survey reported that 10.9 per cent of people 15 and older smoke cigarettes.
finley also says that targets to see cancer mortality reduced are great calls to action, but lung cancer is a heavy hitter. “lung cancer is responsible for more deaths than breast, prostate and colon combined, so you can’t get there without bending the curve on lung cancer. the next great challenge is wide availability of lung cancer screening. it’s not broadly available in ontario or across the country.”
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finley is the clinical lead for lung cancer screening for ontario and an advisor on lung cancer screening for the canadian task force on preventive health care. he’s passionate about critical preventative care for patients and, on the other side of the lung cancer journey, dying with dignity. he spearheaded a palliative suite for patients in their final days.
the canadian partnership against cancer helped develop a lung cancer screening framework for canada, recognizing that low-dose computed tomography (ldct) “is a quick and non-invasive way to screen for lung cancer and can catch the disease earlier.” clinical trials have shown that ldct screening reduces death from lung cancer by 20 to 24 per cent. screening program implementation, slated to begin in 2020, has been slow, many experts say. advocacy voices from the canadian cancer society in atlantic canada, for instance, have recently called on the prince edward island government to get its lung screening program off the ground, cbc news reports. the province committed to a lung screening program as part of the p.e.i. cancer action plan released last year.
impact of cancer on canadian society
the truth is, you probably know someone who’s been through cancer or has a family member who has battled cancer. two in every five canadians will be diagnosed with cancer, which speaks to the growing burden on healthcare services that are already stretched.
the canadian partnership against cancer has taken a deep dive into the economic wallop and quality of life impact of cancer on patients, their families and society. its 2022 study, published in current oncology, analyzed direct health system costs and patients’ and families’ costs, like out-of-pocket costs, medical and non-medical costs, time costs, and indirect costs including productivity losses from time away from employment.
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researchers found that cancer-related costs were $26.2 billion in canada in 2021 with 30 per cent of costs borne by patients and their families.
if you look at cervical cancer in canada, just one example, women under 50 who have critical roles in the family, society and the economy, account for more than half of new cervical cancer cases in canada, b.c. researchers reported in current oncology in 2022.
when these women are incapacitated by cervical cancer, the consequences are significant, they noted: “in 2018, women’s earnings accounted for 46.7 per cent of the family income. loss of this family income when a woman is sick or dies is just one of the substantial, irreversible consequences of cervical cancer on children and families, and as such, preventing cervical cancer has broad societal implications.”
access to care and life-saving therapies is another concern for the cancer community, with world cancer day calling for action to “close the care gap.” it’s a global issue that plays out in canada with hurdles for people living in rural and remote areas and vulnerable populations, such as indigenous people, facing inequities.
there’s also the issue of a cumbersome drug approval process, time to market, availability and financial coverage for patients that often differs by province and territory.
university of alberta oncologist dr. omar abdelsalam asserts that the best treatment for cancer is being part of cutting-edge clinical trials. he’s discovered that people in less populated or rural areas, however, are missing out.
in a study recently published in the american journal of clinical oncology, he looked at canadian cancer clinical trial data recorded in clinicaltrials.gov between 2005 and 2023, and separated them out by province, main urban centres and cancer types. the data showed that the number of cancer clinical trials per 10,000 individuals in each province or territory varied between 6.79 in new brunswick and zero in the three territories. “there is clearly a disparity. three territories and not a single clinical trial conducted in two decades,” he told the university publication folio.
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resources and support available for cancer in canada
there are many associations in canada representing cancer care that support specific cancer types, but the main cancer care organizations include:
connecting with a support organization for emotional support and information on homecare, how to get to your cancer treatment or even where to find a wig or prosthesis can be a huge boost for patients and families dealing with the shock of a diagnosis. the canadian cancer society, for example, has a community services locator to help people connect with services and support in their community.
the future of cancer in canada
“we need to get rid of bald heads and vomiting and diarrhea and focus on any way we can use more effective, safer, less toxic treatments. that theme is permeating oncology across the world and moving very quickly,” says dr. keith stewart, director of princess margaret cancer program at the university health network (uhn) in toronto. “the landscape of cancers is rapidly changing.”
a renowned clinician and researcher, stewart worked at uhn for 13 years before moving to the mayo clinic as director of its centre for individualized medicine. he returned to uhn in 2020 to lead innovation in what is canada’s largest integrated cancer research, teaching and treatment centre.
chemotherapy emerged in the 1970s and made progress, but there are three newer advances that have transformed the science and shape the future, he says.
“the first is the molecular revolution, sequencing of the human genome and cancers that has led to this whole area of targeted therapy and precision oncology. drug companies have been very successful in bringing multiple new therapeutics to market, across the spectrum of many cancers with high success rates of matching genetic mutation to specific drugs.”
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the second game-changer in the cancer community is immunotherapy that boosts the immune system so that it finds and kills cancer cells. stewart points out that there have been significant immunotherapy breakthroughs in the 2000s, and more recently in cellular-based therapies for blood cancers that have had dramatic impact on survival. another example is endometrial cancer, one of the few cancers whose death rate is increasing relentlessly year after year, where immunotherapy has provided a real opportunity for cure when none existed before.
the third pillar in cancer progress is prevention and early detection, he notes, where sophisticated radiation, for instance, uses artificial intelligence to see irregularities before the human eye can and before the patient even has symptoms. princess margaret is piloting new testing that can detect multiple cancers on a single blood test.
“these are major transformations that are dramatically increasing cure rates for some cancers and extending survival for many patients,” he says. “i do believe we can cure more cancers by finding them through early detection. that’s going to be a huge change in how we think of cancer and how we manage it. that really gives me hope.”
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