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Strengthening the Quality of Cancer Services in Ontario Synopsis Cancer Quality Council of Ontario October 2003 Page 2 1 List of Authors Helen Angus Dr. G. Ross Baker Dr. Robert Stuart Bell Dr. Melissa C. Brouwers Dr. George P. Browman Dr. Michael D. Brundage Ian Brunskill Dr. Anna M. Chiarelli Dr. Michelle Cotterchio Michael Decter Dr. William K. Evans Dr. Margaret I. Fitch Anna Gagliardi Debra Gallinger John Garcia Esther Green, RN Dr. Michael Guerriere Dr. Eric Holowaty Dr. Alan Hudson Dr. Bernard Langer Dr. Peggy Leatt Christine Lyons Dr. William J. Mackillop Dr. Verna Mai Peter O’Brien Dr. Lawrence Paszat Melody Roberts Dr. Hartley Stern Dr. Terrence Sullivan Nash Syed Dr. Anthony Whitton Dr. Brent Zanke ...

Page 2 Cancer Care Ontario’s mission is to improve the performance of the cancer system by driving quality, accountability and innovation in all cancer -related services. Page 3 PAGE 3 Ontario Cancer Plan: 2005 Progress Report Table of Contents Our Role . page 5 The Ontario Cancer Plan . page 7 Significant Government Investments . page 9 Major Achievements in 2005 . page 10 Cancer Overview page 12 Priority 1 . page 15 Priority 2 . page 19 Priority 3 . page 25 Priority 4 . page 37 Priority 5 . page 41 Priority 6 . page 47 Improving the Cancer System page 49 Major Goals for 2006 . page 50 Page 4 PAGE 4 Ontario Cancer Plan: 2005 Progress Report The purpose of the clinical accountability frame- work is to create an environment ...

Preamble There is considerable debate over the subject of those therapies, often called unconventional therapies, which are outside of the standard therapies recommended by cancer specialists. Opponents and proponents of their use are equally passionate. As a consequence, bridging the gap between these two polarized factions is a difficult and challenging task and one on which consensus has been difficult to achieve. This position statement is the product of many hours of discussion and debate between various parties – including patients, health care providers, administration and regulatory authorities – and attempts to synthesize their views and those expressed in other venues such as the lay press and medical literature. This statement does not indicate that CCO, as a publicly funded and accountable agency, endorses or disavows the use of any particular type of unproven or unconventional therapy (complimentary, ...

October 1993 Skin Cancer 1 Prepared by Jill Shelley and Michael Dennis 2 Farming may be healthier than other occupations in many respects, but not when it comes to skin cancer . Most skin cancers are related to exposure to the ultraviolet radiation in sunlight. However, a sunburn can occur on an overcast day just as easily as a sunny day. The damage from ultraviolet rays accumulates over time. "The people I’m seeing are usually in their 40s, 50s, 60s, 70s, or 80s. Some of them have numerous skin cancers and precancerous lesions. I’ve seen as many as 10 on one patient," said Dr. Robert Cathey, a dermatologist in Manhattan. Among his patients is Ross Turner, who has farmed full-time or part-time all his life. When Turner reached 54 he had to have treatment each year for eight years for precancerous lesions on his head. "I grew up in the sun, I’ve been ...

RESOLUTIONS AND DECISIONS 103 WHA58.22 Cancer prevention and control The Fifty-eighth World Health Assembly, Having examined the report on the prevention and control of cancer ; 1 Recalling resolutions WHA51.18 and WHA53.17 on the prevention and control of noncommunicable diseases, WHA57.17 on the Global Strategy on Diet, Physical Activity and Health, WHA56.1 on tobacco control, WHA57.12 on the reproductive health strategy, including control of cervical cancer , and WHA57.16 on health promotion and healthy lifestyles; Recognizing the suffering of cancer patients and their families and the extent to which cancer threatens development when it affects economically active members of society; Alarmed by the rising trends of cancer risk-factors, the number of new cancer cases, and cancer morbidity and mortality worldwide, in particular in developing countries; Recognizing ...

Screening Prostate Cancer f o r A f r i c a n A m e r i c a n s A D e c i s i o n G u i d e Page 2 This booklet was developed by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC). Published in October 2003. Page 3 1 To help you understand both sides of the issue, let’s begin with the basics. Is screening right for you? The decision is yours. Some medical experts believe all men should be offered regular screening tests for prostate cancer . Other medical experts do not. Page 4 What is the prostate? The prostate is a walnut-sized gland that only men have. It is part of the reproductive system that makes the fluid that carries sperm. As you can see in the picture ...

The American Cancer Society esti- mates that 25,580 new cases of ovarian cancer will be diagnosed and 16,090 women will die of the disease during 2004. Among U.S. women, ovarian cancer is the se- venth most common cancer and the fifth leading cause of cancer death after lung and bronchus, breast, colorectal, and pancreatic cancers . Ovarian cancer causes more deaths than any other cancer of the female reproductive system. Although the U.S.ovarian cancer incidence rate has changed little since 1975,the mortality rate has decreased by about 9%. According to the National Cancer Institute,from 1996–2000,the age-adjusted ovarian cancer incidence rate for white women (17.9 cancers per 100,000 women) was higher than the corre- sponding rates for Hispanics (14.0), Asians/Pacific Islanders (12.2),blacks (11.9) and American Indians/Alaska ...

LUNG CANCER In 2004, the American Cancer Society estimates that 1 ¦ 7,320 new cases of lung cancer will be diagnosed among men and women in Illinois. ¦ 6,760 men and women will die of lung cancer in Illinois. The CDC National Center for Health Statistics provides the following death rates: The average annual age-adjusted death rates for lung cancer per 100,000 persons, by race, 1997–2001 2,3 Illinois National Overall 57.0 56.2 White 55.6 56.2 Black 74.3 65.2 Hispanic 20.4 24.9 Asian/Pacific Islander 20.6 28.2 American Indian/Alaska Native - 36.3 BREAST CANCER In 2004, the American Cancer Society estimates that 1 ¦ 9,640 new cases of breast cancer will be diagnosed among women in Illinois. ¦ 1,790 women will die of breast cancer ...

LUNG CANCER In 2004, the American Cancer Society estimates that 1 ¦ 2,230 new cases of lung cancer will be diagnosed among men and women in Mississippi. ¦ 2,060 men and women will die of lung cancer in Mississippi. The CDC National Center for Health Statistics provides the following death rates: The average annual age-adjusted death rates for lung cancer per 100,000 persons, by race, 1997–2001 2,3 Mississippi National Overall 70.0 56.2 White 70.0 56.2 Black 70.0 65.2 Hispanic - 24.9 Asian/Pacific Islander - 28.2 American Indian/Alaska Native - 36.3 BREAST CANCER In 2004, the American Cancer Society estimates that 1 ¦ 2,480 new cases of breast cancer will be diagnosed among women in Mississippi. ¦ 460 women will die of breast ...

Cervical cancer is the second most common cancer among women worldwide, with almost half a million new cases each year. Almost 80% of the women affected are in the developing world. However, many of these cases could be prevented from progressing to invasive disease, and potentially death. More so than any other cancer , cervical cancer is a disease which lends itself to early detection and treatment. The effectiveness of cytology screening as a method to reduce the number of invasive cases and deaths resulting from cervical cancer in developed countries has already been demonstrated. Alternative screening tests, such as Visual Inspection with Acetic acid (VIA) and Human Papilloma Virus (HPV) are currently being examined and may prove feasible in the near future. Policy makers and clinicians are faced with the responsibility of establishing and reviewing screening programmes ...

Prostate Cancer : The Public Health Perspective 2001 “We must move toward the development of health messages that reflect the best medical knowledge available to date on prostate cancer to meet the information needs of primary care clinicians and of the public.” David Satcher, MD, PhD Surgeon General DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION Safer • Healthier • People A T A G LANCE Page 2 2 The Burden of Prostate Cancer Prostate cancer is the most commonly diagnosed form of cancer , other than skin cancer , among men in the United States and is second only to lung cancer as a cause of cancer -related death among men. The American Cancer Society estimates that 198,100 new cases of prostate cancer will ...

Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention and Control Mail Stop K-64 4770 Buford Highway, NE Atlanta, GA 30341-3137 Phone (770) 488-4751 Fax (770) 488-4760 Toll-free Voice Information System 1 (888) 842-6355 E-mail cancerinfo@cdc.gov Web site http://www.cdc.gov/ cancer Department of Health and Human Services S U R V I V E C A N C E R A N D L I V E Who Are Cancer Sur vivors? Cancer survivors are people who have been diagnosed with cancer and those people in their lives who are affected by the diagnosis, including family members, friends, and caregivers. “Together CDC and the LAF ar e charting a new course for the public health community to help cancer survivors enjoy all the wonder ...

FACT SHEET 2003 FROM THE DIVISION OF CANCER PREVENTION AND CONTROL Skin Cancer : Preventing America’s Most Common Cancer DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention The Burden of Skin Cancer Skin cancer is the most common form of cancer in the United States. The three major types of skin cancer are the highly curable basal cell and squamous cell carcinomas and the more serious malignant melanoma.The American Cancer Society estimates that during 2003, about 1 million new cases of basal cell or squamous cell carcinoma and about 54,200 new cases of malignant melanoma will be diagnosed. It is also expected that CDC provides leadership for nationwide efforts to reduce illness and death caused by skin cancer . Although these efforts comprise ...

What is Cervical Cancer ? Cancer is a disease in which cells in the body grow out of control. When these abnormal cells are present in the cervix,it is called cervical cancer ,or cancer of the cervix. As the drawing shows, the cervix is the lower, narrower part of the uterus. The uterus is also known as the womb. The upper part of the uterus is where a baby grows when a woman is pregnant. The cervix connects the upper part of the uterus to the vagina (the birth canal). Cervical Cancer BASIC FACTS ON SCREENING AND THE PAP TEST Screening Prevents Cervical Cancer and Saves Lives The Pap test can find abnormal cells in the cervix. These cells may, over time, turn into cancer . This could take several years to happen. If the results of a Pap test show there are abnormal cells that could become cancerous, ...

The Problem Cancer is the second leading cause of death among adults in the United States and affects an estimated 1 in 3 individuals, either through their own diagnosis or that of a loved one (ACS, 2003). Recent innovations in medical technology have led to earlier diagnoses and better treatment of most cancers . As a result, more people diagnosed with cancer are living and surviving each year. Although many public health initiatives address early detection, preven- tion, and control of cancer , public health efforts to address survivorship are relatively new. Survivors face numerous physical, psychological, social, spiritual, and financial issues at diagnosis, during treatment, and for the remaining years of their lives. Many of these issues could be successfully addressed through coordinated public health initiatives. Definition of Cancer Survivor The term “ cancer survivors” ...

Skin Cancer : Preventing America’s Most Common Cancer 2001 “Young people need to know that the risk of getting skin cancer later can be greatly reduced if they start protecting their skin from the sun now.” Jeffrey P. Koplan, MD, MPH Director, Centers for Disease Control and Prevention Get a hat. Seek shade. Cover up. Rub it on. Grab shades. DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION Safer • Healthier • People A T A G LANCE Page 2 2 The Burden of Skin Cancer Skin cancer is the most common form of cancer in the United States. The three major types of skin cancer are the highly curable basal cell and squamous cell carcinomas and the more serious malignant melanoma. The American ...

News Embargoed until 00.01am, Friday 9 September 2005 Future of Cancer Services in Greater Manchester Unveiled A report on cancer services by Dr Chris Harrison, medical director for Greater Manchester Strategic Health Authority, has been published today. It sets out a new model for delivering cancer care across Greater Manchester and Cheshire, which will confirm the Christie in its role as the lead cancer centre for Greater Manchester and Cheshire. It endorses the idea that the Christie should manage a new network of radiotherapy and chemotherapy facilities across Greater Manchester, so that people can receive Christie treatment elsewhere in the conurbation. The Christie should also provide leadership on behalf of the whole network in respect of cancer research and links with academic bodies. It recommends that the hospital continues to provide a clearly defined range of specialist surgery. ...

Dr Chris Harrison September 2005 1 A Framework for Specialist Cancer Services in Greater Manchester and Cheshire Dr. Chris Harrison Medical Director Greater Manchester SHA September 2005 Page 2 Dr Chris Harrison September 2005 2 1. Summary and Recommendations 1. This report proposes a new three-tier framework for the organisation of specialist cancer services in Greater Manchester and Cheshire. This will clarify the services to be provided in particular hospitals and help define expected patient care pathways within a Greater Manchester and Cheshire cancer care system. 2. Cancer is a major cause of premature death and need for health care in Greater Manchester and Cheshire. 3. Survival rates from cancer in Greater Manchester and Cheshire are lower than the best survival ...

PACT: Programme of Action for Cancer Therapy 1 BUILDING PARTNERSHIPS TO STOP THE GLOBAL CANCER EPIDEMIC Grant Raising Prospectus pact@iaea.org PACT PACT Programme of Action for Cancer Therapy Page 2 2 THE LOOMING CANCER PROBLEM Cancer is a leading cause of death globally. The World Health Organization (WHO) estimates that 7.6 million people died of cancer in 2005 and 84 million people will die in the next 10 years if action is not taken. More than 70% of all cancer deaths occur in low and mid- dle income countries, where resources available for prevention, diagnosis and treatment of cancer are limited or nonexistent. There is much scope for action. Over 40% of all cancer can be prevented and some of the ...

HEALTH ADVICE ON PREVENTION AND SCREENING OF CANCER FOR THE HEALTHCARE PROFESSIONALS I. Burden of Cancer in Hong Kong Cancer has been a major cause of illness and the leading cause of death in Hong Kong. There were 21 861 new cases in 2002. The crude incidence rate per 100 000 population was 322.1. There were 11 510 deaths in 2003. The crude mortality rate per 100 000 population was 169.2. In general, 1 in 4 males and 1 in 5 females will have cancer in their lifetime while 1 in 7 males and 1 in 12 females will die from cancer in their lifetime. The burden of cancer in the population has been growing. The proportion of cancer deaths among all deaths has been increased from 27% in 1983 to 32% in 2003. The most common cancers affecting men are lung cancer , colorectal cancer and liver cancer . Among females, the most common cancers are breast cancer , colorectal cancer ...

Part I. Breast Cancer in Kentucky Introduction This report summarizes recommendations of the Kentucky Breast Cancer Task Force on key actions that should be taken to reduce breast cancer incidence, morbidity, and mortality and to increase breast cancer survival rates in the Commonwealth. The Task Force’s recommendations are based on three premises: ? Kentucky women with, and at high risk for, breast cancer should have access to a continuum of prevention and care services, including genetic counseling and testing, early detection, staging evaluation, initial and subsequent treatment, palliative care, supportive therapies, long-term follow-up, rehabilitation, psychosocial services, and hospice care. ? All treatments and services provided to women with breast cancer should meet professionally-accepted standards of care. ? Changes in the organization and ...

Lung Cancer Lung cancer is the deadliest cancer and is by far the leading cause of cancer deaths for both men and women. An estimated 162,460 people are expected to die of lung canc 2006. Tobacco use is the most common cause of lung cancer . Smoking is also respon for most cancers of the lar er in sible ynx, oral cavity and pharynx, esophagus, and bladder. In ddition, it is a cause of kidney, pancreatic, cervical and stomach cancers , as well as emia. PR E bacco, quit. unity. AT IS nces such as arsenic, radon and asbestos • oke SY In t e ms. Later these signs may appear: ugh • ECTION The i ose the dise • • o n to t ve risks and benefits of lung cancer screening for them. If they have not a acute myeloid leuk EV NTION • Don’t use tobacco in any ...

Breast Cancer Facts & Figures 2001-2002 Page 2 Table of Contents What is breast cancer ? 1 Who gets breast cancer ? 1 How has the occurrence of breast cancer changed over time? 3 What factors influence breast cancer survival? 5 What are the known risk factors for breast cancer ? 7 Can breast cancer be prevented? 9 How can breast cancer be detected early? 10 How is breast cancer treated? 11 What research is currently being done on breast cancer ? 14 What resources are available in your community? 15 What is the American Cancer Society doing about breast cancer ? 16 Sources of Statistics 17 References 18 Acknowledgments The production of this report would not have been possible without the efforts of: Cheryll Cardinez, MSPH, Vilma Cokkinides, PhD, ...

SUMMARY CHILDHOOD CANCER INCIDENCE HEALTH CONSULTATION: A REVIEW AND ANALYSIS OF CANCER REGISTRY DATA, 1979-1995 FOR DOVER TOWNSHIP (OCEAN COUNTY), NEW JERSEY September 1997 Division of Environmental and Occupational Health Services Consumer and Environmental Health Services In consultation with the Agency for Toxic Substances and Disease Registry Christine Todd Whitman Len Fishman Governor Commissioner Page 2 1 SUMMARY of the technical report on CHILDHOOD CANCER INCIDENCE HEALTH CONSULTATION: A REVIEW AND ANALYSIS OF CANCER REGISTRY DATA, 1979-1995, FOR DOVER TOWNSHIP, OCEAN COUNTY, NEW JERSEY In the spring of 1995, the New Jersey Department of Health (now the New Jersey Department of Health and Senior Services or NJDHSS) was requested to evaluate childhood ...

World Cancer Report Edited by P. Kleihues and B.W. Stewart 2003; 352 pages ISBN 92 832 0411 5 US$ 25 With more than 10 million new cases every year, cancer has become one of the most devastating diseases world- wide. The causes and types of cancer vary in different ge- ographical regions but in most countries, there is hardly a family without a cancer vic- tim. The disease burden is im- mense, not only for affected individuals but also for their relatives and friends. At the community level, cancer poses considerable chal- lenges for the health care sys- tems in poor and rich coun- tries alike. The World Cancer Report pro- vides a unique global view of cancer . It documents the fre- quency of cancer in different countries, trends in cancer in- cidence and mortality and it describes the known causes ...

UPDATE MARCH 2004 European Association of Urology GUIDELINES ON TESTICULAR CANCER M.P. Laguna (Chairperson), O. Klepp, A. Horwich, F. Algaba, C. Bokemeyer, G. Pizzocaro, G. Cohn-Cedemark, P. Albers Page 2 TABLE OF CONTENTS PAGE 1 BACKGROUND 4 1.1 Methods 4 2 PATHOLOGY AND NATURAL HISTORY 4 3 DIAGNOSIS 5 3.1 Clinical examination 5 3.2 Imaging of the Testis 5 3.3 Serum Tumor Markers at diagnostic 5 3.4 Inguinal exploration and orchiectomy 6 3.5 Organ sparing surgery 6 3.6 Pathological examination of the testis 6 3.7 Diagnosis of Carcinoma in situ (Tin) 6 3.8 Screening 7 4 STAGING 7 4.1 Diagnostic tools 7 4.2 Serum tumour markers. Postorchiectomy ...

relieved even with limited resources, 3 vastly improving a patient’s quality of life. Effective pain relief requires consistent, ongoing, and timely provision of tailored dosages of analgesic medications. Along with home remedies and analgesic medications, palliative care for advanced cervical cancer also can involve therapies such as palliative radiotherapy (single or short course) and chemotherapy. These therapies can help shrink the advancing growth, relieving discomfort, pain, and malodorous vaginal discharge, and decreasing the tendency for the tumor to hemorrhage. Pain management is a priority in palliative care Pain associated with advanced cancer can often be alleviated, but it is a problem that is frequently neglected. Globally, several million people with cancer suffer unnecessarily from pain every day. ...

The Case for Investing in Cervical Cancer Prevention Page 2 The Case for Investing in Cervical Cancer Prevention Cervical Cancer Prevention Issues in Depth #3 Alliance for Cervical Cancer Prevention (ACCP) November 2004 Page 3 About This Publication Authors: Jacqueline Sherris, PhD, PATH Wendy Castro, MHS, PATH Carol Levin, PhD, PATH Ilana Dzuba, MHS, EngenderHealth Silvina Arrossi, MSc, IARC Graphic design: NanCee Sautbine, PATH; Barbara Stout (cover design) For additional copies of this publication, please contact: The Alliance for Cervical Cancer Prevention c/o PATH 1455 NW Leary Way Seattle, WA 98107 USA email: ccppubs@path.org url: www.alliance-cxca.org Acknowledgements The authors extend sincere thanks to the following individuals ...

Improving Screening Coverage Rates of Cervical Cancer Prevention Programs: A Focus on Communities 4 Page 2 Improving Screening Coverage Rates of Cervical Cancer Prevention Programs: A Focus on Communities Cervical Cancer Prevention Issues in Depth #4 Alliance for Cervical Cancer Prevention (ACCP) December 2004 Page 3 About this publication Authors: Patricia Coffey, Ph.D., M.P.H., PATH Silvina Arrossi, M.Sc., IARC Janet Bradley, M.A., EngenderHealth Ilana Dzuba, M.H.S., EngenderHealth Sarah C. White, M.A., PAHO ACCP Community Involvement Affinity Group: Irene Agurto, Ph.D., PAHO Allison Bingham, Ph.D., PATH Amie Bishop, M.S.W., M.P.H., PATH Amy N. Kleine, M.P.H., M.S.W., JHPIEGO Robbyn Lewis, M.P.H., JHPIEGO Jennifer L. Winkler, ...