colorectal cancer disease pathway management, northeast ontario context, dr. amanda hey
DESCRIPTION
Dr. Amanda Hey's presentation from the 2013 Regional Oncology ConferenceTRANSCRIPT
Colorectal Cancer Disease Pathway Management:
North East Ontario Context
Amanda Hey MD CCFP FCFP
Regional Primary Care Lead
Northeast Cancer Centre, HSN
Faculty/Presenter Disclosure
Faculty: Amanda Hey, Annelind Wakegijig, Agnes Kanawase, Roger Boyer II, Jamie White, Michael Loreto, Kathleen Callaghan, Julie Whitten, Traci Franklin, Sherri Baker, Silvana Spadafora, Patrick Critchley
Relationships with commercial interests:•Grants/Research Support: none•Speakers Bureau/Honoraria: none•Consulting Fees: none•Other: none
Disease Pathway Management
Disease Pathway Management
https://www.cancercare.on.ca/ocs/qpi/dispathmgmt/
Disease Pathway Management
https://www.cancercare.on.ca/ocs/qpi/dispathmgmt
Evidence Alone is Never Enough
Evidence
CircumstanceValues
Context
JAMA Users’ Guide to the Medical LiteratureAmerican Medical Association
Panel Sequence
• Panel facilitator presents case• Panelist present their topic sequentially • Audience Q&A at the END of each panel
Panel 1: Screening-Diagnosis
Panel 2: Treatment
Panel 3: Treatment-Survivorship-Palliative
Regional Aboriginal Cancer Lead
Will provide leadership on FNIM cancer care in the region by:
• Engaging and collaborating with primary care providers• Championing the ACS II strategic vision in collaboration with RCP staff• Strategic planning and program design• Peer education and training
8
Colorectal Cancer: A Case for Action
Annelind Wakegijig MD CCFP
Regional Aboriginal Cancer Lead
Northeast Cancer Centre, HSN
Colorectal Cancer Rates 2007
Male Incidence Female Incidence Male Mortality Female Mortality0
10
20
30
40
50
60
70
80
Age Standardized Incidence and Mortality Rates
North East Ontario
Rat
e p
er 1
00,0
00
https://www.cancercare.on.ca/cms/ Accessed October 2013
CRC and Ontario First Nations
Colorectal cancer incidence, Ontario,1968-2001, ages 15-74
Rates age-standardized to the 1991 Canadian populationHorizontal bars around First Nations rates indicate 95% confidence limits
0
10
20
30
40
50
60
70
80
90
Females
Year of diagnosis
1968-1975
1984-1991
1992-1996
1997-2001
1976-1983
Males
0
10
20
30
40
50
60
70
80
90
1976-1983
1968-1975
1984-1991
1992-1996
1997-2001
Source: Surveillance & Aboriginal Cancer Care Units, CCO (2007)
Year of diagnosis
First NationsAll Ontario
Mr. TW: Case History 1
56 yr. First Nation male• Mother was diagnosed with CRC age 66• He was at Residential School as a child• He seeks advice from his social worker• He attends his community health centre• His nurse practitioner assess him at
increased risk for CRC• He is referred for colonoscopy