In the first three months of 2023, just 55 per cent of some of the most aggressive cancers were treated through surgery within the recommended timeframe in Ontario, a new provincial agency report shows.
Overall, 74 per cent of cancer surgeries met the wait time targets from January to March — and while this marked a “gradual increase” since April 2022, it was “still low,” according to Ontario Health’s 2022–23 annual report, which was tabled in the legislature in December.
The super agency's report breaks down cancer surgery wait times for different priority levels. These include P2, where the aim is to operate within 14 days; P3, where the goal is 28 days; and P4, where the target is within 84 days. Though the annual report didn’t include statistics on priority level 1, this category includes surgeries that are recommended to take place within 24 hours.
During the first quarter of last year, the percentage of surgeries that took place within the target wait times increased as the urgency decreased.
For priority level 2, which would include very aggressive cancers, just 55 per cent of surgeries occurred in the target period. For priority level 3, it was 66 per cent, and priority level 4, 91 per cent.
Cancer Care Ontario, which was folded into Ontario Health, has described the wait time target as the time between when a decision is made to treat a cancer with surgery and when the surgery actually occurs.
While Ontario Health considered the number of surgeries meeting the target times to be “low,” the agency reported more positive outcomes when it came to the volume of surgeries and cancer screening tests — both of which took a massive hit during the pandemic.
From January to March last year, 14,813 adult cancer surgeries were performed, up from 14,172 during the same period in 2020, marking 105 per cent of pre-pandemic surgical volumes and surpassing the 90 per cent-plus goal.
Volumes for non-cancer surgeries during the first three months of 2023 stood at 99 per cent of the volume in early 2020 — 136,510 compared to 137,789 pre-pandemic.
"Surgical recovery efforts were maximized by determining the best way to allocate $300 million in funds invested by the ministry to help tackle the backlog of surgeries and diagnostic imaging as a result of the pandemic," Ontario Health's report said of the investment the government announced for 2022–23.
The agency said overall wait times for surgeries improved during that year. At the start, there were close to 88,000 patients waiting for surgery, but that decreased to 70,000 by the end of the fiscal year. There was also an improvement in the number of "long waiters" — the longest waiting patients — with the percentage going from 49 per cent in the first quarter of 2022–23 to 38 per cent in the fourth, according to the report.
Cancer screening test volumes were similar to cancer surgeries, going beyond pre-pandemic volumes. Ontario Health said the target for cancer screening was to reach 105 per cent of pre-pandemic levels.
There were 184,587 fecal tests done from January to March last year, amounting to 105 per cent of the pre-pandemic volumes — 175,287 tests during the same time period in 2020. Mammograms were at 107 per cent compared to pre-pandemic levels — 174,260 versus 162,535. Pap tests reached 109 per cent — 252,269 tests in the third quarter of 2022–23 compared to 224,601 during the same time period in 2019–20.
When the COVID-19 pandemic hit, routine cancer screening was paused, and non-urgent procedures, including some cancer surgeries, were postponed — all in an effort to increase capacity within the health-care system as the province saw massive rises in COVID-19 cases. For example, Ontario Health has reported that in May 2020, cancer surgeries dipped by 35 per cent compared to in 2019.
Ontario Health did not provide the latest statistics on cancer surgery wait times from 2023 before publication.
Rose D’souza, advocacy manager for the Canadian Cancer Society, said the report shows health-care workers are trying hard to increase cancer screening tests and surgeries within the recommended time windows, and that the province needs to make sure people have timely access to these services.
"High demands on health resources and the volume of cancer diagnostics and surgeries will mean people with cancer may be waiting longer to receive care and may receive compromised care. When cancer is found early, it’s often easier to treat. Increased wait times and delays in cancer diagnosis and surgery may result in worse patient outcomes, including an increased risk of death," D'souza said.
"While the data shows progress is underway in Ontario, the Canadian Cancer Society urges the Ontario government to accelerate this work so that more people can access cancer care they need within the recommended target times," she said. "Recent data on the increase of ‘hallway health care’ and Ontario’s ongoing health human resources crisis highlights the urgent need for the Ontario government to immediately increase investments in our health-care system."
D'souza said more than an estimated 94,000 people in the province received a cancer diagnosis last year and that the numbers are continuing to rise.
"When someone is diagnosed with cancer, they should feel confident that they can get the surgery they need without the stress of waiting months or constantly facing delays for treatment," she said.
In response to questions about the "low" number of cancer surgeries meeting the target wait times, Hannah Jensen, a spokesperson for Health Minister Sylvia Jones, said "Our government is not okay with the status quo. That is why with our Your Health plan, we are taking bold and innovative action to connect people to the care they need, when they need it."
She said the government has provided hospitals, through the surgical recovery fund, with close to $1 billion over the past three years to boost operating room hours during evenings and weekends. Jensen said they're also "further leveraging community and surgical diagnostic centres to deliver more publicly funded surgeries and procedures, including adding nearly 50,000 hours of MRI and CT scans."
"Our plan has seen surgical and diagnostic waitlists and wait times continue to decline, with Ontario having the shortest surgical wait times in the country this year. Since January of this year, we have reduced the backlog for Cervical Cancer Screening by 180,000 people and reduced the overall surgical wait list, declining to below pre-pandemic levels with nearly 80 per cent of all Ontarians receiving their surgery within the target time," she added.
