1. Cancer Care Ontario A Organizational Overview S Orientation Workshop July 16, 2014 Sheila M Densham, BA, TEACH Health Promotion Coordinator

2. 2 Provincial government agency Funding for all cancer services in Ontario Cancer prevention and screening Minimizes the effect of cancer Ensures quality service Saving Lives Cancer Care Ontario

3. GOAL Increase screening rates for breast, cervical and colorectal cancers and integrate into primary care Increase patient participation in screening Increase primary care provider performance in screening Establish high-quality, integrated screening program CCO Vision Establish best cancer screening program in North America CCO Vision Establish best cancer screening program in North America 3

4. Ontario Breast Screening Program Ontario Cervical Cancer Screening Program Colon Cancer Check Screening Program 15 Regional Cancer Programs (RCPs) Primary Care Providers 4

5. Prevention: Healthy Lifestyle Gender Age Family history Genetics Physical activity Immunization (HPV) Healthy eating Alcohol Tobacco Cancer screening Non ModifiableModifiable 5

6. Risk Factors and Cancer BreastCervixColorectal Tobacco  Physical Inactivity  Obesity  Poor Nutrition  Alcohol Consumption  6

7. Cancer System Quality Index Web-based public reporting tool Tracks quality and consistency of key cancer services delivered across Ontario's cancer system Statistics provided by the Cancer System Quality Index Snapshot of cancer trends by region CSQI 2014 http://www.csqi.on.ca/ http://www.csqi.on.ca/ 7

8. Strategic Directions 9 Appropriately screened Ontario population GrowSustain Health Equity 8

9. Cancer Screening The application of a test, examination or other procedure for asymptomatic target population to distinguish between: Those who may have the disease and Those who probably do not. 9

10. ‘Organized’ Screening Invites individuals to participate Reminds individuals to be re-screened at the appropriate interval Tracks participants throughout screening and diagnostic process Continually evaluates program quality and performance 10

11. Types of Screening Population-Based Screening Opportunistic Case-Finding Offered systematically to all individuals in a defined target group within a framework of agreed policy, protocols, quality management, monitoring and evaluation Offered to an individual without symptoms of the disease when he/she presents to a healthcare provider for reasons unrelated to that disease 11

12. Diagnostic vs Screening Tests Diagnostic Screening Provided to patients who present with symptoms or those who are at high risk and fall outside screening eligibility criteria Offered at consistent intervals to average risk, asymptomatic individuals, who meet defined eligibility criteria 12

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14. Screening Eligibility Average RiskHigh Risk Two Screening Streams 14

15. First nations Low income Newcomers/immigrants Rural and remote areas Less Likely to Screen for Cancer 15

16. Impact of poverty Access to a female physician Accessibility issues Language & cultural appropriateness issues Barriers to Screening 16

17. Ontario Cancer Statistics 2013 17 Cancer Type# New Cases # Deaths Breast9,300 (F)1,950 (F) Cervical 610 (F) 150 (F) Colorectal4,800 (M) 3,900 (F) (8,700) 1,850 (M) 1,500(F) (3,350) 17

18. Ontario Cancer Statistics 2014 18 Cancer Type# New Cases # Deaths Breast8,900 (F)1,900 (F) Cervical 580 (F) 140 (F) Colorectal4,000(M) 3,600 (F) (7,600) 1,650 (M) 1,450(F) (3,100) 18 http://www.cancer.ca/~/media/cancer.ca/CW/cancer%20information/cancer%2 0101/Canadian%20cancer%20statistics/canadian-cancer-statistics-2013-EN.pdf

19. Screening Activity Report (SAR) PurposeApproach Motivation: Enhance physician motivation to improve screening rates Dashboard displays a comparison of a physician’s screening rates relative to peers in LHIN and province Administration: Provide support to foster improved screening rates Provides detailed lists of all eligible and enrolled patients displaying their screening- related history; clinic staff can be appointed as delegates Failsafe: Identify participants who require further action Patients with abnormal results with no known follow-up are clearly highlighted on the reports Performance: Improve physician adherence to guidelines and program recommendations Methodology based on the program’s clinical guidelines and recommendations for best practice

20. SAR Dashboard

21. What CCO Is Doing Partnerships: Process to determine the follow-up to CARES and other projects PES Pilots: Promote doctor patient discussion Dr. Jones asked me to call you. He noticed that you are due for a Pap test. PES Pilots: Reminder phone calls when patient is due for screening 21

22. What CCO is Doing Introduces cancer screening and cancer prevention to newcomers Available in ten languages Links to key web sites Posted video stories 22

23. What CCO is Doing CCO Correspondence Program - letters sent to all eligible men and women: Invitation to be screened Test Results Reminder to be screened again Health Promotion & Education Aboriginal and Other Special UNS Strategies & Projects Primary Care Initiatives Mobile Coaches 23

24. Questions? Thank you 24