Canada's health-care system needs to brace itself for a major surge in cancer patients.
The number of new cases of the disease diagnosed every year is expected to increase by 40 per cent over the next 15 years, thanks largely to a rising tide of seniors, says a new report.
By the year 2030, an average of 277,000 new cancer cases are expected to be logged every year, up from nearly 200,000 this year and about 155,000 a decade ago, according to Canadian Cancer Statistics 2015, an annual summary of cancer figures and projections published Wednesday by the Canadian Cancer Society, Statistics Canada and the Public Health Agency of Canada.
"What jumps off the page most significantly about this report is actually the sheer number in the predictions – the 40-per-cent rise in the next 15 years," said Sean Cleary, a surgical oncologist at Toronto General Hospital. "We need to be prepared in so many ways to face this."
This is the first time that Canada's most prominent national cancer report has featured a long-range forecast for the burden of cancer.
The national report comes a day after a separate study published in the B.C. Medical Journal predicted British Columbia would see a 57-per-cent increase in cancer cases over a similar period for the same reasons – the population is getting both older and larger, and that means more cancer patients will be flooding Canada's hospitals.
By 2030, one in four Canadians is expected to be 65 or older, up from one in eight in 2005. The overall population is expected to grow by about one-third, or nearly 10 million people, in the same period.
To prepare for the incoming wave of cancer patients, both reports call for comprehensive cancer planning. The health-care system will need more oncologists, specially trained nurses, diagnostic services, cancer centres, cancer therapies and palliative care.
"I think the timing [of the national report,] in a way, is so opportune, because across the country there's so much fiscal restraint and budget-cutting going on," said Eshwar Kumar, co-CEO of the New Brunswick Cancer Network.
"While that's necessary and helps us to streamline our system, there needs to be some investment for long-term planning and some strategic investment in prevention, particularly, to try and change these projections."
As well, as the B.C. report points out, doctors and other health professionals will have to rethink how they approach cancer in more frail, elderly patients who are likely to have other health problems on top of their cancer.
"In that population who are over 70, it is a concern that a lot of the treatments we've evaluated in the past for cancer are really evaluated and meant to be delivered to patients that aren't extremely senior," said Ryan Woods, the scientific director of the B.C. Cancer Registry and one of the co-authors of the B.C. Medical Journal paper. "There could be issues with trying to give very elderly patients the current standard treatments."
The findings of the new reports do not mean individual Canadians run a higher risk of getting cancer in the future.
Overall, cancer incidence rates – which measure the number of new cases per 100,000 people – have held steady recently, while death rates are down and survival rates are up.
Canadian Cancer Statistics 2015 assumes those trends will continue, although it does present several tantalizing alternative forecasts that show how the increase in total new cases could slow down if more Canadians quit smoking, lost weight, stayed out of the sun and embraced regular cancer screening.
Still, it is difficult to counter the effect of the aging population on the total figures. For instance, the national report predicts that by 2030, prostate cancer will surpass lung cancer as the most commonly diagnosed cancer in the country, despite prostate cancer affecting only men.
"Prostate cancer really is a cancer that affects older men," said Robert Nuttall, the assistant director of cancer control policy with the Canadian Cancer Society. "Just that sheer volume of older men is really going to drive the prostate cancer numbers that high."