After two years of nasal swabs and case counts, we understand the importance of proactively testing for disease.
We have even brought COVID-19 screening into our homes, doing millions of rapid tests to detect the disease as early as possible.
But while we focus on finding cases of COVID-19, we are missing too many cases of cancer — which remains the country’s leading cause of death.
Evidence is piling up that health screenings and checkups postponed during the pandemic have caused delays in cancer diagnosis and early treatment, leading to worse health outcomes.
There were about 40 per cent fewer pap tests, mammograms, and tests for colorectal cancer in Ontario in 2020 than a year earlier, and many countries are reporting significant drops in the number of cancers diagnosed over the past couple of years.
These cancers are still out there, though. We just can’t see them yet. And by not diagnosing them early, we are missing the chance to treat them early, when survival rates can be more than three times higher.
This all signals a coming surge of late-stage cancers that could cost countless lives and push our health system to its limits. But we can take this opportunity to learn from the past two years by adopting a more proactive approach to diagnosing and treating cancer.
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Researchers in Ontario and across Canada are already at the forefront of a revolution in how we can detect cancer earlier. By using modern technologies to study cancer at a molecular level, we have identified markers in blood and other biological fluids that indicate the presence of cancer months to years before traditional screening would.
Canadian scientists led a global initiative to analyze common mutations in the DNA of more than 2,600 cancers, which showed how potential tumours could be identified years or even decades before diagnosis. More than 225,000 Ontarians volunteered their personal health information for the Ontario Health Study, which researchers in the province are using to study how to prevent, detect, and treat cancer. There’s also the new Ontario Hereditary Cancer Research Network, spearheaded by the Ontario Institute for Cancer Research — a first-of-its kind data registry aimed at better detecting and treating patients with a genetic predisposition to cancer.
These and other initiatives can generate the tools we need to be proactive about cancer by determining who should be screened, what to look for, and when treatment is necessary. We can envision a future in which surgical biopsies have been replaced with non-invasive blood, saliva, and urine tests — so-called liquid biopsies — for cancer that we can do in our homes, much as we are doing now for COVID-19.
But knowledge and tools will take us only so far. This ground-breaking diagnostic research relies on huge volumes of data to determine who will benefit from which tests. Currently, there are barriers to collecting and sharing data across jurisdictions, which limits what we can learn from research and what we can put into practice.
That’s why we need a coordinated national cancer early detection strategy that connects diagnostics research experts with existing national groups, such as the Canadian Partnership Against Cancer and other agencies, as well as engaged community partners and cancer philanthropic organizations. Together, we can develop and validate innovative methods for detecting cancers that help Canadians get treatment earlier in the disease process — or even before cancer takes hold in the first place — and quickly identify when cancer returns after a period of remission.
This is not a pie-in-the-sky dream. Ontario is already a world leader in cancer research, diagnostic imaging, and data processing, bolstered by significant long-term investment from the provincial government. Nationally, we have a universal health-care system that reaches 38 million people across the country. And our communities have proven eager to participate in large-scale health studies and take an active approach to testing for disease. Now we just need to assemble these resources with an achievable strategy.
The coming months and years are going to be difficult. More Canadians than ever will be diagnosed with advanced cancer, and for many, their diagnoses will come too late.
But a future is within reach where we detect most cancers when they are most treatable, where we are empowered to take charge of our health, and where our response to one urgent health challenge — like a pandemic — doesn’t cause us to lose sight of another.
