Access to Care

Access to Care

Who doesn’t get treatment?  Who should?

Radiotherapy (RT) utilization – the proportion of cancer patients who receive RT – can be
considered a key measure of access.  This has been calculated regionally in several provinces
including British Columbia, Alberta and Ontario. Studies in these provinces have shown that RT
utilization rates fall short of desired benchmarks, currently around 34%.  This suggests that some cancer patients who live in these provinces, and who would benefit from RT are not receiving it.

CPQR is working with stakeholders to help understand weather these shortfalls also exist in other Canadian provinces, and to what extent.  This work is just the first step in understanding inequities in access to radiation treatment across Canada, barriers to access and equitable access for all Canadians and improved cancer outcomes.

What is currently being done

CPQR is thrilled to be working with Jessica Chan, its residency training fellow.  Under Jessica’s
guidance, CPQR is presently gathering data on RT utilization ratios for each Canadian province and conducting a comparison of these ratios across the country.  This involves the collection of data on the total number of new RT patients treated over a 1-year time period, classified by disease site (lung, breast, prostate, colorectal) and intent (curative, palliative).  Engaging RT leads in each province, CPQR is accessing this data by examining each province’s central repository of RT data to obtain the total number of RT patients treated within a province or approaching each RT centre within a province to acquire the number of RT patients treated per centre.

Data on the number of new cancer cases are obtained through each province’s cancer registry, with coordination through the provincial RT lead. By dividing the number of RT patients by the province’s number of new cancer cases, CPQR is examining the RT utilization ratio for each province, and then comparing these ratios in each province with previously established Canadian benchmarks.

What will be done next

Beginning in 2019, CPQR will use a linked incidence-treatment method of measuring utilization.
This work will make it easier to understand variation in radiation treatment use within regions.

Provinces that have the available information will be collected, analyzed and compared with
previously collected ratio data to verify areas and populations with limited care access.