You are displaying the signs of lung cancer.
You have the chest pains, the coughing up of blood and the fatigue associated with the disease, but you need to be screened to know for certain. If you live in Ontario, what’s next?
The province is the largest and most populous in the country, but lung cancer screening is sparse. For potential patients who are hoping to find answers, just finding them can mean travel, and for some, that can mean a 1000-kilometer journey.
With 11,000 cases recorded in Ontario in 2020, and 30,000 estimated nationwide for 2022, lung cancer is the most common form of the disease. In Ontario, getting screened for lung cancer is a long process, which is overseen by the Ontario Lung Cancer Screening Program. Before you can even be screened for cancer, you have to meet the criteria. Currently those 55 to 74 may be referred to the program, and only then if they have smoked cigarettes on a daily basis for 20 years. Even then, if you meet the criteria, you are not guaranteed a screening.
If you do meet the criteria, you then must be referred. Your healthcare provider should be able to do this by filling out a form. Patients do have the option to contact the screening program on their own, but a provider still needs to refer them. This provider can be anyone from a family doctor to emergency room physicians or general practitioners.
But a provider’s referral is still not enough. Now you need to go through a risk assessment. The screening itself is a low dose CT scan that uses X-rays, and as such carries a risk as well. If you don’t pass the risk assessment, you will not be eligible to get screened for lung cancer. Guidelines from Cancer Care Ontario state that those who are eligible to be screened have a two percent or greater chance of developing lung cancer over the next six years.
So, you meet the criteria, gotten referred, and passed the pre-screening, and now are able to get screened for lung cancer. What’s next?
Travelling. And depending on where you live, potentially lots of it.
If you pass the risk assessment, you will then be contacted by one of the screening centres. Often you will be referred to the closest one, but any patient can request to be transferred to the site of their choosing. There are currently four sites to choose from: The Ottawa Hospital, Health Sciences North in Sudbury, Lakeridge Health in Oshawa and the University Health Network in Toronto. Ottawa also runs two affiliate sites at the Renfrew Victoria Hospital and the Cornwall Community Hospital, both of which are an hour’s drive away.
It goes without saying that if you live in Western or Northern Ontario, your options are limited.
Someone living in Thunder Bay will have to drive over 1,000 Kilometers, an 11-hour drive across the province, to get screened in Sudbury. Even for those living closer to the Greater Toronto Area (GTA), the drive isn’t that much better. Windsor patients looking just to get screened will see a four-hour drive, all while navigating Toronto traffic.
Compare this to how lung cancer screening is done in British Columbia. While Ontario has four screening locations, BC has 36. These are located across Vancouver Island, up through Kamloops and Kelowna, and as far away as Dawson’s Creek, Fort St. John and even Prince Rupert. There are as many screening clinics in the Greater Vancouver area alone as there are in the whole province of Ontario, for a population six times smaller.
This needs to change.
CCSN has been advocating through its Cancer Can’t Wait advocacy meetings with policymakers for expanded lung cancer screening access in Ontario. If Ottawa can have affiliate sites in Cornwall and Renfrew, why can’t Sudbury or Toronto have affiliates in Thunder Bay or Windsor?
Screening can be the difference between early versus late diagnosis of lung cancer, between life and death. The more screening centres Ontario opens, the better the outcomes for those diagnosed with lung cancer.