Breaking Down Barriers to Detection and Care in Early-Age-Onset Colorectal Cancer in Canada
Abstract
:1. Introduction
- Increase awareness of the importance of EAOCRC, especially among primary care and the general public;
- Promote the earlier detection of EAOCRC in populations under age 50;
- Invest in research to optimize management pathways in EAOCRC.
1.1. Symposium Goals
1.2. Symposium Organization
1.3. Participants
1.4. Agenda
1.5. Emerging Themes
- The need for improvement in the early detection of CRC in younger populations;
- The application of leading models of care to meet the unique needs in the treatment of younger CRC patients.
2. Breaking Down the Barriers to the Early Detection of CRC in Younger Populations
2.1. CRC Screening Programs in Canada
2.2. Unique Needs of Younger Patients for Early Detection
2.3. How Well Does the Current Crc Screening System Work for Canadians under Age 50?
Gaps in the Current System
2.4. Support for Reducing the CRC Screening Age to 45 in Canada
2.5. Future Advances: Promising Novel Screening Techniques
2.6. Advocating for Change: Lessons Learned from the U.S. Experience
3. Meeting the Unique Treatment Needs of Younger CRC Patients
3.1. Different Needs of EAOCRC Patients
3.2. Leading Practices in the United States and Canada
- The recognition of the very different needs of patients under age 50;
- Multidisciplinary management and research;
- A broad scope of medical and psychosocial services (cancer treatment, mental health, sexual health and fertility, genetics, social work);
- Dedicated resources to educate and coordinate services after referral;
- Collaboration between the centre and family physicians;
- Championship of the creation and ongoing operation of the program.
3.3. Checklist of Programs and Services for EAOCRC Patients
- Utilize a value-based healthcare approach to identify and prioritize the unique needs of younger patients across the continuum of care from prevention to treatment and survivorship/end-of-life.
- Implement multidisciplinary care pathways and integrated research programs
- ○
- Surgical, radiation, oncology treatments;
- ○
- Fertility and sexual health;
- ○
- Mental health;
- ○
- Genetic and biomarker testing;
- ○
- Family supports (child care, financial support);
- ○
- Education and collaboration with primary care and patient organizations;
- ○
- Access to research studies.
- Provide dedicated resources to educate patients and staff, to coordinate and navigate services after referral, and to liaise with external partners.
- Champion the value of a specialized unit serving younger CRC patients.
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Session | Speakers |
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Day 1: Breaking down the barriers | |
Symposium opening | Moderator: Monika Slovinec D’Angelo, Health Scientist, Conference Board of Canada Ms. Filomena Servidio-Italiano, President & CEO, CCRAN |
Key learnings from CCRAN’s June 2021 Symposium | Mary A. De Vera, Epidemiologist, University of British Columbia Darren Brenner, Molecular Epidemiologist, University of Calgary |
Breaking down the barriers to timely detection of colorectal cancer | Moderator: Monika Slovinec D’Angelo, Panel: Ms. Stephanie Florian, Widow of CRC patient, British Columbia Dr. Dan Schiller, Colorectal Surgical Oncologist, University of Alberta Ms. Julie Savard, Endoscopy Nurse Clinician, Jewish General Hospital, Montreal Dr. Lisa Del Giudice, Family Physician, Sunnybrook Health Sciences Centre, Toronto |
Identifying and addressing the needs of younger crc patients | Moderator: Dr. Petra Wildgoose, Lead, Young Adult Colorectal Cancer Program, Sunnybrook Health Sciences Centre Panel: Mr. Marcelino Dolores, Patient Expert Dr. Mary Jane Esplen, Psychosocial Oncologist, University of Toronto Dr. Michael Raphael, GI Medical Oncologist Sunnybrook Health Sciences Center Dr. David Gurau, Reproductive Endocrinologist, Generation Fertility |
Integrative therapies to address treatment-induced toxicities | Dr. Eric Marsden, Director, Marsden Centre for Excellence in Integrative Medicine |
Promoting timely detection of CRC: what can we learn from the American experience? | Moderator: Dr. Robin McGee, Psychologist and Stage 4 Rectal Cancer Patient Panel: Mr. Andrew Spiegel, Executive Director, Global Colon Cancer Association (US) Ms. Martha Raymond, Executive Director, GI Cancers Alliance Inc. (US) Ms. Becky Selig, Director of Patient Education and Research, Fight Colorectal Cancer (US) Mr. Jason Gisser, Board Member, AYA Canada Ms. Dani Taylor, Manager of Programs and Partnerships, Young Adult Cancer Canada (YACC) Ms. Teresa Norris, President, HPV Global Action |
Advancements in colorectal cancer treatments | Moderator: Dr. Scott Berry, GI Medical Oncologist, Kingston Health Sciences Centre Panel: Dr. Chris Lieu, GI Medical Oncologist, University of Colorado Cancer Center Dr. Kim Ma, Department of Haematology-Oncology, Jewish General Hospital, Montreal Dr. Eric Chen, GI Medical Oncologist, Princess Margaret Cancer Centre, Toronto Mr. Steve Slack, Rectal Cancer Patient |
Day 2: Optimizing colorectal cancer care and outcomes | |
What do we know and what have we learned from the June 2021 Symposium? | Dr. Mary A. De Vera, Epidemiologist, University of British Columbia Dr. Clarence Wong, Gastroenterologist, University of Alberta |
Improving the EAOCRC patient care pathway | Moderator: Dr. Monika Slovinec D’Angelo, Health Scientist, Conference Board of Canada Panel: Ms. Hayley Painter, Young Adult mCRC Survivor Dr. Dan Schiller, Colorectal Surgical Oncologist, University of Alberta Ms. Julie Savard, Endoscopy Nurse Clinician, Jewish General Hospital, Montreal Dr. Anna Wilkinson, Family Physician, Ottawa Academic Family Health Team |
Defining value and building system capacity for timely detection of EAOCRC | Moderator: Dr. Jill Tinmouth, Lead Scientist, ColonCancerCheck Program, Sunnybrook Research Institute, Toronto Panel: Dr. Petra Wildgoose, Lead, Young Adult Colorectal Cancer Program, Sunnybrook Health Sciences Centre, Toronto Dr. Yooj Ko, Medical Oncologist, Sunnybrook Health Sciences Centre, Toronto Ms. Eva Villalba, Executive Director, Quebec Cancer Coalition Mr. Jason Sutherland, Economist, Centre for Health Services and Policy Research, Vancouver Dr. Ian Bookman, Gastroenterologist, St. Joseph’s Health Centre, Hamilton Mr. Fred Horne, Horne and Associates, Edmonton |
Best practices for systematically improving management of EAOCRC | Moderator: Dr. Sharlene Gill, GI Medical Oncologist, BC Cancer Agency Panel: Dr. Petra Wildgoose, Lead, Young Adult Colorectal Cancer Program, Sunnybrook Health Sciences Centre, Toronto Dr. Kimmie Ng, GI Medical Oncologist, Dana-Farber Cancer Institute, Boston Dr. Robin Mendelsohn, Gastroenterologist, Memorial Sloan Kettering Cancer Center, New York City Dr. Aparna Parikh, GI Oncologist, Massachusetts General Hospital Cancer Center, Boston Dr. Cathy Eng, GI Medical Oncologist, Vanderbilt-Ingram Cancer Centre, Nashville |
Accessing innovations in CRC diagnostics and treatment | Moderator: Dr. Michael Raphael, GI Medical Oncologist, Sunnybrook Health Sciences Centre, Toronto Panel: Dr. Arvind Dasari, Medical Oncologist, MD Anderson Cancer Centre, Houston Dr. Aaron Pollett, Anatomic Pathologist, Mount Sinai Hospital, Toronto Dr. Stephanie Snow, Medical Oncologist, QEII Health Sciences Centre, Halifax Dr. Clarence Wong, Gastroenterologist, University of Alberta, Edmonton Dr. José Perea, Colorectal Surgeon, Jimenez Diaz Foundation University Hospital, Madrid, Spain Mr. Bill McGinley, Stage IV Colorectal Cancer Patient, Toronto |
Key Lessons from U.S. Advocacy Experience | Canadian Policy Opportunities |
---|---|
Data are crucial to support policy change:
| Conduct broad cost–benefit analyses:
|
Collaboration is essential:
| Advocate with pan-Canadian bodies and provinces
|
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Raphael, M.J.; Wildgoose, P.; Servidio-Italiano, F.; De Vera, M.A.; Brenner, D.; D’Angelo, M.S.; McGee, R.; Berry, S.; Wong, C.; Gill, S. Breaking Down Barriers to Detection and Care in Early-Age-Onset Colorectal Cancer in Canada. Curr. Oncol. 2023, 30, 9392-9405. https://doi.org/10.3390/curroncol30110680
Raphael MJ, Wildgoose P, Servidio-Italiano F, De Vera MA, Brenner D, D’Angelo MS, McGee R, Berry S, Wong C, Gill S. Breaking Down Barriers to Detection and Care in Early-Age-Onset Colorectal Cancer in Canada. Current Oncology. 2023; 30(11):9392-9405. https://doi.org/10.3390/curroncol30110680
Chicago/Turabian StyleRaphael, Michael J., Petra Wildgoose, Filomena Servidio-Italiano, Mary A. De Vera, Darren Brenner, Monika Slovinec D’Angelo, Robin McGee, Scott Berry, Clarence Wong, and Sharlene Gill. 2023. "Breaking Down Barriers to Detection and Care in Early-Age-Onset Colorectal Cancer in Canada" Current Oncology 30, no. 11: 9392-9405. https://doi.org/10.3390/curroncol30110680