Cancer surgery wait times increased in 2022 as the Canadian health-care system continued to work through a surgical backlog from the COVID-19 pandemic, according to a new report.
The report released Thursday by the Canadian Institute for Health Information (CIHI), found that between April and September 2022, half of Canadian cancer patients waited for about one to three days longer for their breast, bladder, colorectal and lung cancer surgery compared with before the pandemic. The average wait time increased by about 12 days for prostate cancer.
At the beginning of the pandemic, provinces asked their hospitals to ramp down elective surgeries in order to help curb the spread of the virus. As a result, many cancer patients had to forego their surgeries.
“We know that (hospitals) tried to maintain a priority on cancer surgeries, but we can see that there were still about 20 per cent fewer cancer surgeries in the three-year period than there were prior to the pandemic,” Tracy Johnson, director of Health System Analytics at CIHI, told Global News.
“So that suggests that there was some triaging going on. And there was there were some people who were delayed.”
CIHI’s report showed Canadians continue to face longer wait times for many surgeries such as knee and hip replacements and cataract procedures.
During the first 31 months of the pandemic, about 937,000 (14 per cent) fewer surgeries were performed in Canada compared with before the pandemic, the study found.
The largest decrease in surgeries occurred during the first four months of the pandemic (March to June 2020), and also during the Delta (May 2021) and Omicron (January 2022) waves.
Although a lot of non-emergency surgeries were pushed, cancer and cardiac procedures were some of the last ones to be delayed and the first ones to come back, Johnson said.
Many hospitals prioritized cancer surgery because of the life-or-death situation, she added, but there were still delays in the system. This is mainly because of ongoing staffing shortages, screening delays, travel disruptions and even patients’ reluctance to see their primary care providers in person.
“It does suggest that some patients had to wait for one to two days more for their surgery,” Johnson said. “So, if your surgery was scheduled for a Monday and it was now Wednesday, would that make a huge difference? Maybe not. But, like all other surgeries, there are outliers that are not necessarily very good to hear about.”
But backlogs still persist.
Natalie Fitzgerald with the Canadian Partnership Against Cancer (CPAC), warned the health-care system must perform more cancer surgeries than pre-pandemic levels in order to catch up. But that isn’t happening.
“The backlog that has persisted over the last three years continues, and there could be a surge of cancer cases that will present itself in the future,” she said.
That’s because the lockdown at the beginning of the pandemic could have caused some cancer cases to go undetected due to missed diagnoses, she added.
Drops in cancer diagnoses
Not only were surgery wait times impacted during the first few months of the pandemic, but there were also fewer new cancer cases diagnosed in that time.
And the expected surge in cancer diagnoses as access to health care normalizes could put further pressure on the current surgery backlog, according to CIHI.
There were around six per cent fewer new cancer cases in 2020 compared with the average from 2015 to 2019, according to CPAC, which is likely due to the drop in cancer screening and reduced access to primary care.
In April 2020 there was nearly a 50 per cent decrease in new prostate cancer cases, 43 per cent fewer new colorectal cancer cases, 31 per cent fewer new breast cancer cases and 30 per cent fewer new lung cancer cases, CPAC found.
“At the beginning of the pandemic, they shut down MRIs and CT machines because a lot of them are in hospitals,” Johnson explained.
Diagnostic imaging affects cancer surgeries because if you can’t get diagnosed, then you can’t get treated, she said.
Because of the diagnostic delays, CPAC said there may be some cancer that is now farther along in a patient or some cases that will remain undiagnosed.
“The later the risk of people getting diagnosed the great the risk for the patient,” Fitzgerald said.
In fact, according to CPAC, studies have shown that treatment delays by even four weeks can be associated with as much as six to 13 per cent increased risk of death.
The CIHI report said the expected surge in cancer diagnoses combined with ongoing staffing shortages, including specialized nurses and technicians, will “likely affect the ability of health systems to ramp up surgeries.”
“Continued monitoring will be critical to assess the impact of strategies and planning efforts that are being implemented to address these challenges,” the report stated.
— with files from Irelyne Lavery