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Cancer Can’t Wait!
Fourth survey on COVID-19 and
Cancer Care reveals cancer patient &
caregiver concerns as society opens
Thursday June 23rd, 2022
1:00 pm
Presented by Marjut Huotari,
VP – Healthcare Insights, Leger
416-262-4200
1
Research context and objectives
Research methodology
• Recruitment
• Research methodology
Key findings
Conclusion
Q&A
1
2
3
4
5
OVERVIEW
2
RESEARCH CONTEXT AND OBJECTIVES
Leger, on behalf of the Canadian Cancer Survivor Network (CCSN), conducted a fourth wave of the study to assess
the extent to which the disruption of cancer care caused by COVID-19 impacts cancer patients and caregivers, from
an emotional and physical wellness perspective.
• Level of anxiety and concerns about receiving adequate cancer care now that COVID-19
restrictions are being lifted
• How are patients and caregivers interacting with the doctor managing their cancer
• virtual consults, in person visits, etc.
• How do they rate the quality of care in the past 6 months?
• COVID-19 vaccination among patients and caregivers
• Impact of COVID-19 restrictions being lifted
• Impact of relaxation of restrictions on daily life
• Perceptions about provincial government lifting restrictions
• Likelihood to continue to follow COVID-19 related precautions
• What could the government do to make patients and caregivers feel more comfortable
• % of cancer patients tested positive for COVID-19 and their COVID-19 journey
Key topics addressed
in the survey
3
RESEARCH METHODOLOGY – SAMPLE SIZE
This wave, data collection took place from April
13th to May 12th, 2022.
Previous wave, Total sample of 1,502 - data
collection took place from June 10th to July 4th,
2021.
 Web survey of 1,353 Canadians, including
1,100 Canadians diagnosed with cancer,
and 253 Caregivers.
 The survey was made available in both
English and French.
REGIONAL ACHIEVEMENTS
QUE 30%
ON 31%
AB 10%
BC 14% SK 3%
ATL 6%
MB 5%
4
RESEARCH METHODOLOGY – RECRUITMENT
SCREENING CRITERIA:
• 18 years or older and currently living in Canada
• Respondents qualified as:
 A patient, if they were diagnosed with cancer
 A caregiver, if a currently living family member / someone they
care for was diagnosed with cancer. A caregiver should be
supporting patients in either of the following ways:
• Provide emotional support
• Attend doctor’s appointments where their cancer may be discussed
• Look for information on treatment options, for example, on the Internet, or in books
• Support the person in other ways, e.g. by driving to and from doctor’s appointments
RECRUITMENT:
• All respondents were recruited via our LEO PANEL – Leger’s proprietary consumer panel
with nearly 500,000 members (largest in Canada)
5
KEY FINDINGS
KEY STUDY FINDINGS
Overall, cancer patients are significantly more likely to have CONSULTED an HCP in the past 6 months vs. during the
pandemic, more so in-person, and majority say they were HIGHLY SATISFIED WITH THE QUALITY OF CANCER CARE
received in the past 6 months.
LEVEL OF ANXIETY ABOUT RECEIVING ADEQUATE CANCER CARE DROPPED THROUGHOUT THE PANDEMIC from its
highest levels when COVID-19 was declared a pandemic; however, now as restrictions are being lifted, anxiety levels
are likely to rise again.
When prompted, respondents report being QUITE CONCERNED about their ability to be CARED FOR IN AN ER or a
HOSPITAL, SEE A DOCTOR IN-PERSON and being able to GET TESTS AND TREATMENT IN A TIMELY MANNER as
restrictions begin to be lifted.
Many respondents mention that they are NOT COMFORTABLE with their PROVINCIAL GOVERNMENT LIFTING
RESTRICTIONS, mainly because they believe that IT IS TOO SOON and COVID CONTINUES TO BE A THREAT.
Patients as well as caregivers indicate HIGH LIKELIHOOD to CONTINUE FOLLOWING COVID-19 SAFETY MEASURES,
including WEARING A MASK FOR THE FORESEEABLE FUTURE.
1
2
4
5
3
8
RESPONDENT PROFILE – PATIENTS
Even split by gender Tend to skew older: 64 YEARS (64) on average
Fairly regionally representative
across Canada
QUE 32%
ON 32%
AB 10%
BC 14%
SK 3% ATL 5%
MB 4%
BREAST (25%) and PROSTATE (19%) cancer
account for about 2 in 5 cases.
Other cancers among ~1 in 10 patients include
colon / rectal and melanoma.
25% 19%
Stage 1
27%
Stage 2
11%
Stage 3
10%
Stage 4 /
Metastatic
9%
Remission
31%
1 in 9 (13%) say they are unsure of their stage of cancer.
<2 YEARS
25%
2-5 YEARS
48%
6-10 YEARS
16%
>10 YEARS
11%
TIME SINCE
DIAGNOSIS
varies greatly
among patients;
~3 IN 4
were diagnosed in
the PAST 5
YEARS.
46%
53%
Good mix of locations by population
(54%) (46%)
(23%) (11%) (8%) (7%) (39%)
(21%)
(38%)
(21%)
(20%)
(26%) (21%)
(#) represents W3 (Q2 2021) data
1% said other
RURAL: 29% (27%)
TOWN/CITY: 49% (52%)
URBAN/METRO: 23% (21%)
9
RESPONDENT PROFILE – CAREGIVERS
Good mix of all ages: 50 YEARS (47) on average
Fairly regionally representative across
Canada
QUE 22%
ON 26%
AB 10%
BC 16%
SK 6% ATL 10%
MB 8%
<2 YEARS
44%
2-5 YEARS
32%
6-10 YEARS
14%
>10 YEARS
10%
TIME SINCE
DIAGNOSIS
varies but skews
towards more
recently diagnosed;
NEARLY HALF
were diagnosed
within the last 2
years
43%
57%
RURAL: 23% (21%)
TOWN/CITY: 52% (59%)
URBAN/METRO: 26% (19%)
Good mix of locations by population
RELATIONSHIP TO THE CANCER PATIENT
Spouse / partner
– 26%
Daughter (in-law)
– 16%
Mother (in-law) –
12%
Father (in-law) –
10%
Even split by gender
1 in 10 (11%) say they are unsure of their stage of cancer.
(64%) (36%)
Most common cancer types of
person being cared for
PROSTATE
CANCER: 17%
COLON / RECTAL
CANCER: 11%
BREAST
CANCER: 29%
LUNG
CANCER: 17%
(49%)
(36%)
(10%)
(5%)
(21%) (25%) (11%) (17%) (15%)
(25%) (12%) (6%) (11%)
(#) represents W3 (Q2 2021) data
10
Overall, ABOUT TWO-THIRDS were VERY SATISFIED with the QUALITY OF CANCER CARE received in
the past 6 months. Unaided, MORE respondents, especially patients, say this wave that they DON’T
HAVE CONCERNS ABOUT RECEIVING CARE even as COVID related restrictions are being lifted.
PATIENTS CAREGIVERS
SATISFACTION WITH QUALITY OF CANCER CARE RECEIVED IN THE PAST 6 MONTHS
10%
5%
15%
70%
Very satisfied
Somewhat satisfied
Somewhat unsatisfied /
not at all satisfied
Don’t know
6%
17%
34%
44% Very satisfied
Somewhat satisfied
Somewhat unsatisfied /
not at all satisfied
Don’t know
MAIN REASONS FOR BEING SOMEWHAT SATISFIED / SOMEWHAT UNSATISFIED / NOT AT ALL SATISFIED:
 Unprofessional HCPs (losing files, forgetting appointments, not faxing prescriptions, etc.)
 Status of appointments / treatment unknown
 Not getting timely treatment / care / delays in services
 Doctor not available / appointments cancelled
PATIENTS CAREGIVERS
MAIN CONCERN ABOUT RECEIVING CARE NOW THAT COVID-19 RESTRICTIONS ARE BEING LIFTED (UNAIDED)
18%
8%
5%
3%
46%
Access to health care (treatment, HCPs, tests, etc.)
Fear of getting COVID-19
Safety / Security / COVID-19 protocols
Fear of getting sick / concerned for health
None / no concerns
12%
19%
10%
9%
21%
 Overall, 65% (vs. 56% in W3) are very
satisfied with the quality of care
received during COVID-19
 Patients report higher satisfaction
with the quality of care received
this wave
 Lack of organization in healthcare
system was highlighted as the
main reason for being unsatisfied
with quality of cancer care
received in the past 6 months
 Unaided, significantly more
patients and caregivers say
they don’t have any concerns
about receiving care as
restrictions are being lifted.
Although less than last wave, a
few continue to be concerned
about access to healthcare and
contracting COVID-19
(60%)
(#) represents W3
(Q2 2021) data
(48%)
(19%)
(5%)
(-)
(27%)
(54%)
(24%)
(9%)
(-)
(6%)
11
HEALTHCARE PROVIDERS INTERACTED WITH IN THE PAST 6 MONTHS
AMONG THOSE WHO
INTERACTED WITH EACH
PHYSICIAN IN THE PAST
6 MONTHS
PATIENTS are MORE LIKELY to have INTERACTED with an HCP IN THE PAST 6 MONTHS versus during the
pandemic. SIGNIFICANT INCREASE reported in IN-PERSON CONSULTATIONS, however, VIRTUAL
CONSULTATIONS continue to be WIDELY USED.
PATIENTS CAREGIVERS
70%
60%
40%
32%
Specialists
Family doctor/ GP
Pharmacists
Allied healthcare professionals
73%
81%
60%
55%
(61%)
(54%)
(79%)
(80%)
(67%)
(64%)
 Patients are significantly more likely to have
interacted with HCPs in the past 6 months
vs. during the pandemic
 Patients in ON, QC and MB are more likely
to have consulted a specialist in the past 6
months vs. other provinces
 Recently diagnosed patients are more likely
to say they have interacted with specialists
(92%) and GPs (74%) in the past 6 months
(34%)
(27%)
 Overall, physician interactions are
significantly more likely to have
been in-person in the past 6
months
 Drop in virtual interactions in the
past 6 months; however, two-
thirds continue to interact with
GPs virtually and about half with
specialists
 Among all virtual modes of
interactions, telephone consults
continue to be used the most
MODES OF INTERACTION IN
THE PAST 6 MONTHS
77%
62%
66%
55%
GPs Specialists
In-person
Virtual
(telephone, video consult,
e-mail, instant messaging,
text / SMS)
94%
91%
89%
90%
79%
67%
67%
50%
GPs Specialists
86%
92%
85%
85%
(79%)
(61%)
(79%)
(64%)
(59%)
(68%)
(63%)
(58%)
MAIN REASONS FOR BEING SOMEWHAT UNSATISFIED / NOT AT ALL SATISFIED WITH VIRTUAL CONSULTS:
 Would rather have an in-person consult
 Found it difficult communicating virtually
 Bad service (lack of follow up, vague answers, misdiagnosis, etc.)
 It was hard to access physician
 Some concerns were not addressed
SATISFACTION
(VERY/SOMEWHAT
SATISFIED)
SATISFACTION
(VERY/SOMEWHAT
SATISFIED)
(#) represents W3 (Q2 2021) data
12
With relaxation in COVID-19 related restrictions, LEVEL OF ANXIETY about RECEIVING ADEQUATE CANCER
CARE is likely to RISE AGAIN.
LEVEL OF ANXIETY* ABOUT RECEIVING ADEQUATE CANCER CARE
*% VERY + SOMEWHAT CONCERNED
50%
43%
33%
39%
73%
70%
57% 59%
Patients Caregivers
AS COVID-19 WAS
BEING DECLARED
A PANDEMIC
(no vaccines available in
March 2020)
DURING SECOND /
THIRD WAVE
[when vaccines started to be
available / were available
(between January and April 2021)]
DURING FOURTH WAVE
[as boosters became available
(between December 2021 and
February 2022)]
NOW AS RESTRICTIONS
ARE BEING RELAXED
 Female patients (42%) report being more anxious than male patients (35%) about receiving adequate cancer care now that restrictions are being lifted.
 Recently diagnosed patients (49%) are more anxious than those diagnosed 2+ years ago.
 Patients (42%) and Caregivers in urban areas (69%) are more are more anxious about them / the person they care for receiving adequate cancer care.
NOTE: RECENTLY DIAGNOSED = DIAGNOSED <2 YEARS AGO
13
*% VERY + SOMEWHAT
CONCERNED
When prompted, patients as well as caregivers report SIGNIFICANT INCREASE IN CONCERNS about
RECEIVING ADEQUATE CARE (compared to last wave) now that COVID-19 restrictions are being lifted.
Ability to be cared for in ER
Ability to receive hospital care other than ER
Being able to receive cancer treatment in a timely fashion
Being able to get tests related to cancer
Being able to get help for side effects or new symptoms
Coverage and funding of new treatments
Being able to receive post-treatment rehabilitative care
Being able to see the doctor managing my cancer in-person
Availability of new cancer treatments
Shortages of medication to treat and/or manage my cancer
TOTAL PATIENTS CAREGIVERS
55%
53%
51%
47%
46%
45%
45%
42%
42%
41%
52%
49%
47%
42%
42%
41%
39%
38%
38%
36%
67%
68%
66%
67%
63%
60%
65%
58%
57%
58%
MAIN CONCERNS* ABOUT FOLLOWING NOW THAT COVID-19 RESTRICTIONS ARE BEING LIFTED
 Unaided, contracting COVID-19 continues to be the main concern for all, more so among caregivers, and more than previous wave
 About half feel comfortable visiting a hospital or ER for cancer care. Those who do not feel comfortable suggest variety of
measures that would make them feel comfortable, including:
• Strictly following COVID-19 safety guidelines, including maintaining mask mandates
• Seen in a timely manner / getting an appointment
• Everyone be fully vaccinated / Mandatory vaccination
• Cleanliness / sanitary measures in place
32%
31%
34%
28%
30%
32%
27%
26%
30%
23%
W3
57%
56%
60%
54%
60%
57%
57%
57%
54%
50%
W3
38%
37%
42%
34%
36%
38%
34%
37%
36%
31%
W3
14
COVID-19 CONTINUES to AFFECT MOST ASPECTS of everyone’s life, causing FEARS that their CANCER
WILL PROGRESS and IMPACTING OVERALL STATE of HEALTH and WELLBEING.
TOTAL PATIENTS CAREGIVERS
AFFECT* OF COVID-19 ON THE FOLLOWING ASPECTS OF LIFE
NOTE: RECENTLY DIAGNOSED = DIAGNOSED <2 YEARS AGO
* % SIGNIFICANT + SOME AFFECT
Your overall state of health and wellbeing
Fears that your cancer will progress
Mental health
Exercise
Time to care for others in your family
Financial wellbeing
Diet/ nutrition
Ability to work (inside or outside the home)
52%
49%
47%
46%
40%
38%
34%
30%
48%
42%
42%
42%
34%
33%
29%
25%
71%
75%
70%
62%
67%
60%
54%
49%
(44%)
(39%)
(27%)
(22%)
 STAGE 2 – 57%
 RECENTLY DIAGNOSED – 56%
 RECENTLY DIAGNOSED – 56%
(#) represents W3 (Q2 2021) data
15
HALF of those surveyed mentioned that they are NOT COMFORTABLE with their PROVINCIAL GOVERNMENT
LIFTING RESTRICTIONS. Although many say that this would have no impact on daily life as they would continue to
follow safety measures, 1 in 5 say it would have a NEGATIVE IMPACT.
PERCEPTIONS ABOUT EASING COVID-19 RESTRICTIONS
PATIENTS CAREGIVERS
1%
49%
30%
20%
Very comfortable
Somewhat comfortable
not very / not at all
comfortable
Don’t know
7%
51%
24%
18%
Very comfortable
Somewhat comfortable
Not very / not at all
comfortable
Don’t know
LEVEL OF COMFORT WITH PROVINCIAL GOVT
LIFTING COVID-19 RESTRICTIONS
MAIN REASONS FOR VERY/
SOMEWHAT COMFORTABLE
(UNAIDED):
 Need to learn to live with it /
Tired of it all / It's been two
years
 We are capable of managing
the risk ourselves
 The virus is not as serious/
dangerous as it once was
 Herd immunity
MAIN REASONS FOR NOT VERY/NOT
AT ALL COMFORTABLE (UNAIDED):
 COVID-19 cases are going up
 It's too soon / too early
 Masks/Restrictions should be
maintained
 COVID-19 is still here / Not over
yet
 Afraid to catch COVID-19 /
immunocompromised / at risk
 New variants / Another wave
56%
19%
25%
45%
20%
13%
NO
IMPACT
NEGATIVE
IMPACT
POSITIVE
IMPACT
• Continue to follow
COVID-19 / safety
protocols
• Avoid going out /
crowded places
• Increased stress /
anxiety / fear
• Stay home more /
more isolated
• Afraid to catch COVID
• Able to get out more
• Able to see friends/
family
• Freedom
• We need to learn to
live with it
34%
20%
13%
14%
11%
18%
9%
7%
4%
4%
Continue to follow
COVID-19 protocols
(NET)
Mask mandates /
wearing masks
COVID-19 protocols
other than masks
More/Better
vaccinations/boosters
More info / Bring back
daily updates
PATIENTS CAREGIVERS
IMPACT OF RELAXATION OF
RESTRICTIONS ON DAILY LIFE
(UNAIDED)
MAIN SUGGESTIONS FOR GOVT TO
MAKE PEOPLE FEEL MORE
COMFORTABLE NOW THAT
RESTRICTIONS ARE BEING LIFTED
(UNAIDED)
16
Even as COVID-19 related restrictions being to lift, patients as well as caregivers indicate HIGH LIKELIHOOD to
CONTINUE FOLLOWING THE SAFETY PROTOCOLS, including WEARING A MASK IN PUBLIC.
PATIENTS
COVID-19 RISK ASSESSMENT
 ABOUT THREE-QUARTERS ANTICIPATE THAT THEY /
PERSON THEY CARE FOR WOULD CONTINUE TO WEAR A
MASK FOR THE FORSEEABLE FUTURE. REST ANTICIPATE
WEARING IT FOR, ON AVERAGE, 6 MONTHS OR MORE.
 MAIN REASONS TO CONTINUE TO WEAR A MASK
(UNAIDED):
 To stay safe / reduce risk / remain cautious
 COVID-19 is still here / not over yet
 Afraid of catching COVID-19 /
immunocompromised at risk
 Continue wearing a mask as long as necessary
/ certain settings
 New variants / Another wave
 COVID-19 cases are going up
CAREGIVERS
50%
50%
43%
43%
44%
45%
34%
42%
Provincial Chief
Medical Officer of
Health
Provincial Ministry of
Health
Federal Chief Medical
Officer of Health
Local Public Health
Officials
 26% PATIENTS report being told by
a physician that they are
immunocompromised. This number
rises to 41% among CAREGIVERS for
the person they care for
*% VERY + SOMEWHAT LIKELY
93%
83%
82%
73%
61%
58%
32%
32%
92%
84%
83%
78%
62%
69%
39%
53%
Wash / sanitize my hands
frequently
Keep socially distanced
WEAR A MASK IN PUBLIC
Avoid seeing people in large
groups
Continue to use virtual
appointments
Use online sources for
shopping
Avoid in-person appointments
Avoid going to stores
PUBLIC HEALTH GUIDANCE
FOLLOWED FOR OWN RISK
ASSESSMENT
LIKELIHOOD* TO CONTINUE TO DO THE
FOLLOWING NOW THAT COVID-19
RESTRICTIONS ARE BEING LIFTED
17
COVID-19 VACCINATION
HIGH VACCINATION RATES among those surveyed, with MOST having RECEIVED two doses and a
booster dose. HIGH LIKELHOOD to get ANOTHER BOOSTER dose if made available and recommended by
the government.
PATIENTS CAREGIVERS
96% 89%
PERSON CAREGIVER
IS TAKING CARE OF
87%
% RECEIVED A
COVID-19 VACCINE
 3% PATIENTS and about 7% CAREGIVERS / PERSON THEY CARE FOR do not intend to take COVID-19 vaccine, mainly because they are
concerned about side effects and they feel the vaccines are not tested enough, they don’t trust the vaccines and vaccines are ineffective
0%
9%
91%
2%
14%
84%
2%
20%
78%
One dose
Two doses
Two doses and a booster dose
80% 73%
73%
11% patients say they have
been tested to see if COVID-
19 vaccine works for them
22% caregivers say person they
care for have been tested to see if
COVID-19 vaccine works for them
% HAD COVID-19
PATIENTS
16%
Among patients who had COVID-19:
• Vast majority had mild /
moderate COVID
• 16% say they have LONG COVID
(n=171)
PERSON CAREGIVER
IS TAKING CARE OF
18%
Among caregivers who say person
they care for have had COVID-19:
• 4 in 5 had mild / moderate COVID
• 38% say they have LONG COVID
(n=45)
% LIKELY TO GET
ANOTHER
BOOSTER SHOT
18
CONCLUSIONS
OVERALL, NEARLY TWO-THIRDS (65%) say they were HIGHLY SATISFIED WITH THE QUALITY OF CANCER CARE received in the past 6
months. PATIENTS report being MUCH MORE SATISFIED this wave compared to last wave (Q2, 2021).
• Unaided, SIGNIFICANT INCREASE in proportion who say they DON’T HAVE ANY CONCERNS about RECEIVING CARE now that
restrictions are being lifted. This wave, CLOSE TO HALF of the PATIENTS (46% vs. 27% in W3) and 1 IN 5 CAREGIVERS (21% vs.
6% in W3) report NO CONCERNS. Among those who have concerns, ACCESS TO HEALTHCARE and CONTRACTING COVID-19
CONTINUE to be main concerns (although less than last wave).
MAJORITY of patients and caregivers report having INTERACTED with a PHYSICIAN in the PAST 6 MONTHS. Patients are significantly
more likely to have interacted with HCPs in the past 6 months vs. during the pandemic.
• While NOTICEABLE INCREASE observed in IN-PERSON CONSULTATIONS, VIRTUAL CONSULTATIONS, especially via telephone,
continue to be WIDELY USED.
• Overall, high satisfaction reported with all modes of interactions.
Both patients and caregivers mention that their ANXIETY LEVELS about RECEIVING ADEQUATE CANCER CARE DROPPED SIGNIFICANTLY
THROUGHOUT THE PANDEMIC from its peak when COVID-19 was declared a pandemic up to early this year when booster doses
became available; however, NOW AS RESTRICTIONS BEGIN TO LIFT, ANXIETY LEVELS ARE STARTING TO SHOW AN UPWARD TREND.
• When prompted, respondents indicate that they are QUITE CONCERNED about their ability to be CARED FOR IN AN ER or a
HOSPITAL, SEE A DOCTOR IN-PERSON and being able to GET TESTS AND TREATMENT IN A TIMELY MANNER as restrictions
begin to be lifted.
1
2
3
19
CONCLUSIONS
HALF of the patients and caregivers surveyed say that they are NOT COMFORTABLE with their PROVINCIAL GOVERNMENT LIFTING
RESTRICTIONS, mainly because they feel COVID IS NOT OVER YET, it CONTINUES TO BE A THREAT and that IT IS TOO SOON.
• 1 in 5 believe RELAXATION OF RESTRICTIONS will have a NEGATIVE IMPACT on their daily life as they would avoid going out /
avoid crowded places, stay home more / more isolated and it’ll increase stress/anxiety/fear.
• To make them FEEL MORE COMFORTABLE, respondents suggest that government should CONTINUE WITH COVID-19
PROTOCOLS, including MASK MANDATES.
Even as COVID-19 related restrictions being to lift, patients as well as caregivers indicate HIGH LIKELIHOOD to CONTINUE FOLLOWING
COVID-19 SAFETY MEASURES.
• 4 in 5 say they would CONTINUE TO WEAR A MASK. MAJORITY of those anticipate wearing it FOR THE FORESEEABLE FUTURE
while REST for, on average, 6 MONTHS OR MORE.
ALMOST UNIVERSAL COVERAGE of COVID-19 VACCINE among those surveyed, with MAJORITY vaccinated with TWO DOSES AND A
BOOSTER DOSE.
• ~1 IN 6 RESPONDENTS (16% patients and 18% caregivers say the person they care for) have HAD COVID-19, with the vast
majority reporting it was mild/moderate. Although on a low sample size, among patients who have had COVID-19, 1 in 6
(16%) are suffering from long COVID. This number rises to 2 in 5 among caregivers.
4
5
6
20
CANADIAN CANCER SURVIVOR NETWORK
CONTACT INFO
1750 Courtwood Crescent, Suite 210
Ottawa, ON K2C 2B5
Telephone / Téléphone : 613-898-1871
E-mail: jmanthorne@survivornet.ca or info@survivornet.ca
Website: www.survivornet.ca
Twitter: @survivornetca
Facebook: www.facebook.com/CanadianSurvivorNet
Instagram: @survivornet_ca
Pinterest: http://pinterest.com/survivornetwork/
21

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CCSN Impact on Cancer Patients W4 Webinar June 23 2022.

  • 1. Cancer Can’t Wait! Fourth survey on COVID-19 and Cancer Care reveals cancer patient & caregiver concerns as society opens Thursday June 23rd, 2022 1:00 pm Presented by Marjut Huotari, VP – Healthcare Insights, Leger 416-262-4200 1
  • 2. Research context and objectives Research methodology • Recruitment • Research methodology Key findings Conclusion Q&A 1 2 3 4 5 OVERVIEW 2
  • 3. RESEARCH CONTEXT AND OBJECTIVES Leger, on behalf of the Canadian Cancer Survivor Network (CCSN), conducted a fourth wave of the study to assess the extent to which the disruption of cancer care caused by COVID-19 impacts cancer patients and caregivers, from an emotional and physical wellness perspective. • Level of anxiety and concerns about receiving adequate cancer care now that COVID-19 restrictions are being lifted • How are patients and caregivers interacting with the doctor managing their cancer • virtual consults, in person visits, etc. • How do they rate the quality of care in the past 6 months? • COVID-19 vaccination among patients and caregivers • Impact of COVID-19 restrictions being lifted • Impact of relaxation of restrictions on daily life • Perceptions about provincial government lifting restrictions • Likelihood to continue to follow COVID-19 related precautions • What could the government do to make patients and caregivers feel more comfortable • % of cancer patients tested positive for COVID-19 and their COVID-19 journey Key topics addressed in the survey 3
  • 4. RESEARCH METHODOLOGY – SAMPLE SIZE This wave, data collection took place from April 13th to May 12th, 2022. Previous wave, Total sample of 1,502 - data collection took place from June 10th to July 4th, 2021.  Web survey of 1,353 Canadians, including 1,100 Canadians diagnosed with cancer, and 253 Caregivers.  The survey was made available in both English and French. REGIONAL ACHIEVEMENTS QUE 30% ON 31% AB 10% BC 14% SK 3% ATL 6% MB 5% 4
  • 5. RESEARCH METHODOLOGY – RECRUITMENT SCREENING CRITERIA: • 18 years or older and currently living in Canada • Respondents qualified as:  A patient, if they were diagnosed with cancer  A caregiver, if a currently living family member / someone they care for was diagnosed with cancer. A caregiver should be supporting patients in either of the following ways: • Provide emotional support • Attend doctor’s appointments where their cancer may be discussed • Look for information on treatment options, for example, on the Internet, or in books • Support the person in other ways, e.g. by driving to and from doctor’s appointments RECRUITMENT: • All respondents were recruited via our LEO PANEL – Leger’s proprietary consumer panel with nearly 500,000 members (largest in Canada) 5
  • 7. KEY STUDY FINDINGS Overall, cancer patients are significantly more likely to have CONSULTED an HCP in the past 6 months vs. during the pandemic, more so in-person, and majority say they were HIGHLY SATISFIED WITH THE QUALITY OF CANCER CARE received in the past 6 months. LEVEL OF ANXIETY ABOUT RECEIVING ADEQUATE CANCER CARE DROPPED THROUGHOUT THE PANDEMIC from its highest levels when COVID-19 was declared a pandemic; however, now as restrictions are being lifted, anxiety levels are likely to rise again. When prompted, respondents report being QUITE CONCERNED about their ability to be CARED FOR IN AN ER or a HOSPITAL, SEE A DOCTOR IN-PERSON and being able to GET TESTS AND TREATMENT IN A TIMELY MANNER as restrictions begin to be lifted. Many respondents mention that they are NOT COMFORTABLE with their PROVINCIAL GOVERNMENT LIFTING RESTRICTIONS, mainly because they believe that IT IS TOO SOON and COVID CONTINUES TO BE A THREAT. Patients as well as caregivers indicate HIGH LIKELIHOOD to CONTINUE FOLLOWING COVID-19 SAFETY MEASURES, including WEARING A MASK FOR THE FORESEEABLE FUTURE. 1 2 4 5 3 8
  • 8. RESPONDENT PROFILE – PATIENTS Even split by gender Tend to skew older: 64 YEARS (64) on average Fairly regionally representative across Canada QUE 32% ON 32% AB 10% BC 14% SK 3% ATL 5% MB 4% BREAST (25%) and PROSTATE (19%) cancer account for about 2 in 5 cases. Other cancers among ~1 in 10 patients include colon / rectal and melanoma. 25% 19% Stage 1 27% Stage 2 11% Stage 3 10% Stage 4 / Metastatic 9% Remission 31% 1 in 9 (13%) say they are unsure of their stage of cancer. <2 YEARS 25% 2-5 YEARS 48% 6-10 YEARS 16% >10 YEARS 11% TIME SINCE DIAGNOSIS varies greatly among patients; ~3 IN 4 were diagnosed in the PAST 5 YEARS. 46% 53% Good mix of locations by population (54%) (46%) (23%) (11%) (8%) (7%) (39%) (21%) (38%) (21%) (20%) (26%) (21%) (#) represents W3 (Q2 2021) data 1% said other RURAL: 29% (27%) TOWN/CITY: 49% (52%) URBAN/METRO: 23% (21%) 9
  • 9. RESPONDENT PROFILE – CAREGIVERS Good mix of all ages: 50 YEARS (47) on average Fairly regionally representative across Canada QUE 22% ON 26% AB 10% BC 16% SK 6% ATL 10% MB 8% <2 YEARS 44% 2-5 YEARS 32% 6-10 YEARS 14% >10 YEARS 10% TIME SINCE DIAGNOSIS varies but skews towards more recently diagnosed; NEARLY HALF were diagnosed within the last 2 years 43% 57% RURAL: 23% (21%) TOWN/CITY: 52% (59%) URBAN/METRO: 26% (19%) Good mix of locations by population RELATIONSHIP TO THE CANCER PATIENT Spouse / partner – 26% Daughter (in-law) – 16% Mother (in-law) – 12% Father (in-law) – 10% Even split by gender 1 in 10 (11%) say they are unsure of their stage of cancer. (64%) (36%) Most common cancer types of person being cared for PROSTATE CANCER: 17% COLON / RECTAL CANCER: 11% BREAST CANCER: 29% LUNG CANCER: 17% (49%) (36%) (10%) (5%) (21%) (25%) (11%) (17%) (15%) (25%) (12%) (6%) (11%) (#) represents W3 (Q2 2021) data 10
  • 10. Overall, ABOUT TWO-THIRDS were VERY SATISFIED with the QUALITY OF CANCER CARE received in the past 6 months. Unaided, MORE respondents, especially patients, say this wave that they DON’T HAVE CONCERNS ABOUT RECEIVING CARE even as COVID related restrictions are being lifted. PATIENTS CAREGIVERS SATISFACTION WITH QUALITY OF CANCER CARE RECEIVED IN THE PAST 6 MONTHS 10% 5% 15% 70% Very satisfied Somewhat satisfied Somewhat unsatisfied / not at all satisfied Don’t know 6% 17% 34% 44% Very satisfied Somewhat satisfied Somewhat unsatisfied / not at all satisfied Don’t know MAIN REASONS FOR BEING SOMEWHAT SATISFIED / SOMEWHAT UNSATISFIED / NOT AT ALL SATISFIED:  Unprofessional HCPs (losing files, forgetting appointments, not faxing prescriptions, etc.)  Status of appointments / treatment unknown  Not getting timely treatment / care / delays in services  Doctor not available / appointments cancelled PATIENTS CAREGIVERS MAIN CONCERN ABOUT RECEIVING CARE NOW THAT COVID-19 RESTRICTIONS ARE BEING LIFTED (UNAIDED) 18% 8% 5% 3% 46% Access to health care (treatment, HCPs, tests, etc.) Fear of getting COVID-19 Safety / Security / COVID-19 protocols Fear of getting sick / concerned for health None / no concerns 12% 19% 10% 9% 21%  Overall, 65% (vs. 56% in W3) are very satisfied with the quality of care received during COVID-19  Patients report higher satisfaction with the quality of care received this wave  Lack of organization in healthcare system was highlighted as the main reason for being unsatisfied with quality of cancer care received in the past 6 months  Unaided, significantly more patients and caregivers say they don’t have any concerns about receiving care as restrictions are being lifted. Although less than last wave, a few continue to be concerned about access to healthcare and contracting COVID-19 (60%) (#) represents W3 (Q2 2021) data (48%) (19%) (5%) (-) (27%) (54%) (24%) (9%) (-) (6%) 11
  • 11. HEALTHCARE PROVIDERS INTERACTED WITH IN THE PAST 6 MONTHS AMONG THOSE WHO INTERACTED WITH EACH PHYSICIAN IN THE PAST 6 MONTHS PATIENTS are MORE LIKELY to have INTERACTED with an HCP IN THE PAST 6 MONTHS versus during the pandemic. SIGNIFICANT INCREASE reported in IN-PERSON CONSULTATIONS, however, VIRTUAL CONSULTATIONS continue to be WIDELY USED. PATIENTS CAREGIVERS 70% 60% 40% 32% Specialists Family doctor/ GP Pharmacists Allied healthcare professionals 73% 81% 60% 55% (61%) (54%) (79%) (80%) (67%) (64%)  Patients are significantly more likely to have interacted with HCPs in the past 6 months vs. during the pandemic  Patients in ON, QC and MB are more likely to have consulted a specialist in the past 6 months vs. other provinces  Recently diagnosed patients are more likely to say they have interacted with specialists (92%) and GPs (74%) in the past 6 months (34%) (27%)  Overall, physician interactions are significantly more likely to have been in-person in the past 6 months  Drop in virtual interactions in the past 6 months; however, two- thirds continue to interact with GPs virtually and about half with specialists  Among all virtual modes of interactions, telephone consults continue to be used the most MODES OF INTERACTION IN THE PAST 6 MONTHS 77% 62% 66% 55% GPs Specialists In-person Virtual (telephone, video consult, e-mail, instant messaging, text / SMS) 94% 91% 89% 90% 79% 67% 67% 50% GPs Specialists 86% 92% 85% 85% (79%) (61%) (79%) (64%) (59%) (68%) (63%) (58%) MAIN REASONS FOR BEING SOMEWHAT UNSATISFIED / NOT AT ALL SATISFIED WITH VIRTUAL CONSULTS:  Would rather have an in-person consult  Found it difficult communicating virtually  Bad service (lack of follow up, vague answers, misdiagnosis, etc.)  It was hard to access physician  Some concerns were not addressed SATISFACTION (VERY/SOMEWHAT SATISFIED) SATISFACTION (VERY/SOMEWHAT SATISFIED) (#) represents W3 (Q2 2021) data 12
  • 12. With relaxation in COVID-19 related restrictions, LEVEL OF ANXIETY about RECEIVING ADEQUATE CANCER CARE is likely to RISE AGAIN. LEVEL OF ANXIETY* ABOUT RECEIVING ADEQUATE CANCER CARE *% VERY + SOMEWHAT CONCERNED 50% 43% 33% 39% 73% 70% 57% 59% Patients Caregivers AS COVID-19 WAS BEING DECLARED A PANDEMIC (no vaccines available in March 2020) DURING SECOND / THIRD WAVE [when vaccines started to be available / were available (between January and April 2021)] DURING FOURTH WAVE [as boosters became available (between December 2021 and February 2022)] NOW AS RESTRICTIONS ARE BEING RELAXED  Female patients (42%) report being more anxious than male patients (35%) about receiving adequate cancer care now that restrictions are being lifted.  Recently diagnosed patients (49%) are more anxious than those diagnosed 2+ years ago.  Patients (42%) and Caregivers in urban areas (69%) are more are more anxious about them / the person they care for receiving adequate cancer care. NOTE: RECENTLY DIAGNOSED = DIAGNOSED <2 YEARS AGO 13
  • 13. *% VERY + SOMEWHAT CONCERNED When prompted, patients as well as caregivers report SIGNIFICANT INCREASE IN CONCERNS about RECEIVING ADEQUATE CARE (compared to last wave) now that COVID-19 restrictions are being lifted. Ability to be cared for in ER Ability to receive hospital care other than ER Being able to receive cancer treatment in a timely fashion Being able to get tests related to cancer Being able to get help for side effects or new symptoms Coverage and funding of new treatments Being able to receive post-treatment rehabilitative care Being able to see the doctor managing my cancer in-person Availability of new cancer treatments Shortages of medication to treat and/or manage my cancer TOTAL PATIENTS CAREGIVERS 55% 53% 51% 47% 46% 45% 45% 42% 42% 41% 52% 49% 47% 42% 42% 41% 39% 38% 38% 36% 67% 68% 66% 67% 63% 60% 65% 58% 57% 58% MAIN CONCERNS* ABOUT FOLLOWING NOW THAT COVID-19 RESTRICTIONS ARE BEING LIFTED  Unaided, contracting COVID-19 continues to be the main concern for all, more so among caregivers, and more than previous wave  About half feel comfortable visiting a hospital or ER for cancer care. Those who do not feel comfortable suggest variety of measures that would make them feel comfortable, including: • Strictly following COVID-19 safety guidelines, including maintaining mask mandates • Seen in a timely manner / getting an appointment • Everyone be fully vaccinated / Mandatory vaccination • Cleanliness / sanitary measures in place 32% 31% 34% 28% 30% 32% 27% 26% 30% 23% W3 57% 56% 60% 54% 60% 57% 57% 57% 54% 50% W3 38% 37% 42% 34% 36% 38% 34% 37% 36% 31% W3 14
  • 14. COVID-19 CONTINUES to AFFECT MOST ASPECTS of everyone’s life, causing FEARS that their CANCER WILL PROGRESS and IMPACTING OVERALL STATE of HEALTH and WELLBEING. TOTAL PATIENTS CAREGIVERS AFFECT* OF COVID-19 ON THE FOLLOWING ASPECTS OF LIFE NOTE: RECENTLY DIAGNOSED = DIAGNOSED <2 YEARS AGO * % SIGNIFICANT + SOME AFFECT Your overall state of health and wellbeing Fears that your cancer will progress Mental health Exercise Time to care for others in your family Financial wellbeing Diet/ nutrition Ability to work (inside or outside the home) 52% 49% 47% 46% 40% 38% 34% 30% 48% 42% 42% 42% 34% 33% 29% 25% 71% 75% 70% 62% 67% 60% 54% 49% (44%) (39%) (27%) (22%)  STAGE 2 – 57%  RECENTLY DIAGNOSED – 56%  RECENTLY DIAGNOSED – 56% (#) represents W3 (Q2 2021) data 15
  • 15. HALF of those surveyed mentioned that they are NOT COMFORTABLE with their PROVINCIAL GOVERNMENT LIFTING RESTRICTIONS. Although many say that this would have no impact on daily life as they would continue to follow safety measures, 1 in 5 say it would have a NEGATIVE IMPACT. PERCEPTIONS ABOUT EASING COVID-19 RESTRICTIONS PATIENTS CAREGIVERS 1% 49% 30% 20% Very comfortable Somewhat comfortable not very / not at all comfortable Don’t know 7% 51% 24% 18% Very comfortable Somewhat comfortable Not very / not at all comfortable Don’t know LEVEL OF COMFORT WITH PROVINCIAL GOVT LIFTING COVID-19 RESTRICTIONS MAIN REASONS FOR VERY/ SOMEWHAT COMFORTABLE (UNAIDED):  Need to learn to live with it / Tired of it all / It's been two years  We are capable of managing the risk ourselves  The virus is not as serious/ dangerous as it once was  Herd immunity MAIN REASONS FOR NOT VERY/NOT AT ALL COMFORTABLE (UNAIDED):  COVID-19 cases are going up  It's too soon / too early  Masks/Restrictions should be maintained  COVID-19 is still here / Not over yet  Afraid to catch COVID-19 / immunocompromised / at risk  New variants / Another wave 56% 19% 25% 45% 20% 13% NO IMPACT NEGATIVE IMPACT POSITIVE IMPACT • Continue to follow COVID-19 / safety protocols • Avoid going out / crowded places • Increased stress / anxiety / fear • Stay home more / more isolated • Afraid to catch COVID • Able to get out more • Able to see friends/ family • Freedom • We need to learn to live with it 34% 20% 13% 14% 11% 18% 9% 7% 4% 4% Continue to follow COVID-19 protocols (NET) Mask mandates / wearing masks COVID-19 protocols other than masks More/Better vaccinations/boosters More info / Bring back daily updates PATIENTS CAREGIVERS IMPACT OF RELAXATION OF RESTRICTIONS ON DAILY LIFE (UNAIDED) MAIN SUGGESTIONS FOR GOVT TO MAKE PEOPLE FEEL MORE COMFORTABLE NOW THAT RESTRICTIONS ARE BEING LIFTED (UNAIDED) 16
  • 16. Even as COVID-19 related restrictions being to lift, patients as well as caregivers indicate HIGH LIKELIHOOD to CONTINUE FOLLOWING THE SAFETY PROTOCOLS, including WEARING A MASK IN PUBLIC. PATIENTS COVID-19 RISK ASSESSMENT  ABOUT THREE-QUARTERS ANTICIPATE THAT THEY / PERSON THEY CARE FOR WOULD CONTINUE TO WEAR A MASK FOR THE FORSEEABLE FUTURE. REST ANTICIPATE WEARING IT FOR, ON AVERAGE, 6 MONTHS OR MORE.  MAIN REASONS TO CONTINUE TO WEAR A MASK (UNAIDED):  To stay safe / reduce risk / remain cautious  COVID-19 is still here / not over yet  Afraid of catching COVID-19 / immunocompromised at risk  Continue wearing a mask as long as necessary / certain settings  New variants / Another wave  COVID-19 cases are going up CAREGIVERS 50% 50% 43% 43% 44% 45% 34% 42% Provincial Chief Medical Officer of Health Provincial Ministry of Health Federal Chief Medical Officer of Health Local Public Health Officials  26% PATIENTS report being told by a physician that they are immunocompromised. This number rises to 41% among CAREGIVERS for the person they care for *% VERY + SOMEWHAT LIKELY 93% 83% 82% 73% 61% 58% 32% 32% 92% 84% 83% 78% 62% 69% 39% 53% Wash / sanitize my hands frequently Keep socially distanced WEAR A MASK IN PUBLIC Avoid seeing people in large groups Continue to use virtual appointments Use online sources for shopping Avoid in-person appointments Avoid going to stores PUBLIC HEALTH GUIDANCE FOLLOWED FOR OWN RISK ASSESSMENT LIKELIHOOD* TO CONTINUE TO DO THE FOLLOWING NOW THAT COVID-19 RESTRICTIONS ARE BEING LIFTED 17
  • 17. COVID-19 VACCINATION HIGH VACCINATION RATES among those surveyed, with MOST having RECEIVED two doses and a booster dose. HIGH LIKELHOOD to get ANOTHER BOOSTER dose if made available and recommended by the government. PATIENTS CAREGIVERS 96% 89% PERSON CAREGIVER IS TAKING CARE OF 87% % RECEIVED A COVID-19 VACCINE  3% PATIENTS and about 7% CAREGIVERS / PERSON THEY CARE FOR do not intend to take COVID-19 vaccine, mainly because they are concerned about side effects and they feel the vaccines are not tested enough, they don’t trust the vaccines and vaccines are ineffective 0% 9% 91% 2% 14% 84% 2% 20% 78% One dose Two doses Two doses and a booster dose 80% 73% 73% 11% patients say they have been tested to see if COVID- 19 vaccine works for them 22% caregivers say person they care for have been tested to see if COVID-19 vaccine works for them % HAD COVID-19 PATIENTS 16% Among patients who had COVID-19: • Vast majority had mild / moderate COVID • 16% say they have LONG COVID (n=171) PERSON CAREGIVER IS TAKING CARE OF 18% Among caregivers who say person they care for have had COVID-19: • 4 in 5 had mild / moderate COVID • 38% say they have LONG COVID (n=45) % LIKELY TO GET ANOTHER BOOSTER SHOT 18
  • 18. CONCLUSIONS OVERALL, NEARLY TWO-THIRDS (65%) say they were HIGHLY SATISFIED WITH THE QUALITY OF CANCER CARE received in the past 6 months. PATIENTS report being MUCH MORE SATISFIED this wave compared to last wave (Q2, 2021). • Unaided, SIGNIFICANT INCREASE in proportion who say they DON’T HAVE ANY CONCERNS about RECEIVING CARE now that restrictions are being lifted. This wave, CLOSE TO HALF of the PATIENTS (46% vs. 27% in W3) and 1 IN 5 CAREGIVERS (21% vs. 6% in W3) report NO CONCERNS. Among those who have concerns, ACCESS TO HEALTHCARE and CONTRACTING COVID-19 CONTINUE to be main concerns (although less than last wave). MAJORITY of patients and caregivers report having INTERACTED with a PHYSICIAN in the PAST 6 MONTHS. Patients are significantly more likely to have interacted with HCPs in the past 6 months vs. during the pandemic. • While NOTICEABLE INCREASE observed in IN-PERSON CONSULTATIONS, VIRTUAL CONSULTATIONS, especially via telephone, continue to be WIDELY USED. • Overall, high satisfaction reported with all modes of interactions. Both patients and caregivers mention that their ANXIETY LEVELS about RECEIVING ADEQUATE CANCER CARE DROPPED SIGNIFICANTLY THROUGHOUT THE PANDEMIC from its peak when COVID-19 was declared a pandemic up to early this year when booster doses became available; however, NOW AS RESTRICTIONS BEGIN TO LIFT, ANXIETY LEVELS ARE STARTING TO SHOW AN UPWARD TREND. • When prompted, respondents indicate that they are QUITE CONCERNED about their ability to be CARED FOR IN AN ER or a HOSPITAL, SEE A DOCTOR IN-PERSON and being able to GET TESTS AND TREATMENT IN A TIMELY MANNER as restrictions begin to be lifted. 1 2 3 19
  • 19. CONCLUSIONS HALF of the patients and caregivers surveyed say that they are NOT COMFORTABLE with their PROVINCIAL GOVERNMENT LIFTING RESTRICTIONS, mainly because they feel COVID IS NOT OVER YET, it CONTINUES TO BE A THREAT and that IT IS TOO SOON. • 1 in 5 believe RELAXATION OF RESTRICTIONS will have a NEGATIVE IMPACT on their daily life as they would avoid going out / avoid crowded places, stay home more / more isolated and it’ll increase stress/anxiety/fear. • To make them FEEL MORE COMFORTABLE, respondents suggest that government should CONTINUE WITH COVID-19 PROTOCOLS, including MASK MANDATES. Even as COVID-19 related restrictions being to lift, patients as well as caregivers indicate HIGH LIKELIHOOD to CONTINUE FOLLOWING COVID-19 SAFETY MEASURES. • 4 in 5 say they would CONTINUE TO WEAR A MASK. MAJORITY of those anticipate wearing it FOR THE FORESEEABLE FUTURE while REST for, on average, 6 MONTHS OR MORE. ALMOST UNIVERSAL COVERAGE of COVID-19 VACCINE among those surveyed, with MAJORITY vaccinated with TWO DOSES AND A BOOSTER DOSE. • ~1 IN 6 RESPONDENTS (16% patients and 18% caregivers say the person they care for) have HAD COVID-19, with the vast majority reporting it was mild/moderate. Although on a low sample size, among patients who have had COVID-19, 1 in 6 (16%) are suffering from long COVID. This number rises to 2 in 5 among caregivers. 4 5 6 20
  • 20. CANADIAN CANCER SURVIVOR NETWORK CONTACT INFO 1750 Courtwood Crescent, Suite 210 Ottawa, ON K2C 2B5 Telephone / Téléphone : 613-898-1871 E-mail: jmanthorne@survivornet.ca or info@survivornet.ca Website: www.survivornet.ca Twitter: @survivornetca Facebook: www.facebook.com/CanadianSurvivorNet Instagram: @survivornet_ca Pinterest: http://pinterest.com/survivornetwork/ 21