All.Can report urges health officials, decision-makers to 'do the right thing by patients'

Reviewed by James Ives, M.Psych. (Editor)Jul 24 2019

The international All.Can cancer initiative has today published a major report urging health officials, governments and decision-makers to 'do the right thing by patients' when developing cancer care plans and policies by taking patient insights into account in all aspects of treatment and care.

Patient insights on cancer care: opportunities for improving efficiency highlights four major areas of cancer care inefficiency from the patient perspective. All.Can defines inefficiency in cancer care as anything that does not focus on what matters to patients.

"Patients are often forgotten when it comes to cancer care planning," said Alex Filicevas, Head of EU Affairs at the European Cancer Patient Coalition and member of All.Can international's steering committee. "With the prevalence, complexity and costs of cancer rising across the globe, it is imperative to listen to what patients say would improve their experience of care. Ignoring the findings of this report would be a missed opportunity to do the right thing by patients and make changes that could make a real difference."

Based on results from a large, international patient survey of nearly 4,000 people affected by different cancers across 10 countries, the report identifies four key areas for efficiency improvements based on patient insights:

1. Ensuring a swift, accurate and appropriately delivered diagnosis

• A quarter of the survey's respondents (26%) stated their initial diagnosis was the most inefficient part of their cancer care journey.
• Almost a third (32%) of respondents whose cancer was diagnosed outside of a screening programme said their cancer was diagnosed as something else - either once or multiple times.

1. Improving information-sharing, support and shared decision-making

• Almost half (47%) of respondents did not feel sufficiently involved in deciding which treatment option was best for them.

• 39% of respondents said that they were never, or only sometimes, given enough support to deal with any ongoing symptoms and side effects.

1. Making integrated multidisciplinary care a reality for all patients

• Seven out of ten respondents (69%) said they needed psychological support either during or after their cancer care - but a third (34%) of them said it was 'not available'.
• A quarter of respondents (24%) said they did not have access to support from allied health professionals such as dietitians and physiotherapists.

1. Addressing the financial implications of cancer

• 26% of respondents reported a loss of employment income as a result of their cancer care and treatment.
• 36% of respondents cited travel costs as a financial implication of their cancer care and treatment.

The authors of the report urge policymakers and the entire cancer community to act on these findings - as making these changes could make a real difference to patient outcomes and experiences of care, and the financial impact cancer has on patients, families, the health system and society as a whole.

This is supported by existing evidence: faster diagnosis can improve patient survival and is associated with reduced treatment costs for many cancers.[i] Shared decision-making is associated with improved patient outcomes.[ii] Cancer patients with depression have a 39% higher risk of mortality,[iii] higher healthcare utilisation, and higher healthcare expenditure than patients who do not have depression[iv] - pointing to the need for appropriate psychological support.

Lost productivity due to cancer is estimated to cost €52 billion per year in the European Union, due to early death and lost working days[v] - and protective social policies that either help patients return to work or protect them from financial insecurity due to cancer can have a huge impact on reducing this burden.

"It is so important that, as physicians, we listen to what patients are telling us in this survey," said All.Can international member Christobel Saunders, breast cancer surgeon and Professor of Surgical Oncology at the University of Western Australia. "Each of the areas identified represents an opportunity to improve cancer care for patients and provide truly patient-driven care."

According to the World Health Organization, at least 20% of all healthcare spending is thought to be wasted on inefficient treatment and care.[vi]