Alain Sotto Business of Aging Summit 2012


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Dr. Alain Sotto's presentation from the Business of Aging Summit 2012 held at the MaRS Discovery District April 30, 2012.

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  • The sanofi-aventis Healthcare Survey Since 1998, the healthcare survey has monitored the pulse of Canadians with employer-sponsored health benefit plans. They continue to track respondents ’ overall satisfaction with the healthcare system as a whole and their own benefit plan, their concerns about their health and the health of their families, and their understanding of certain chronic illness Life at Cancer Risk™ framework developed by RiskAnalytica To quantify the impact of The Canadian Strategy For Cancer Control (CSCC), the current version of the Life at Cancer Risk tool was used to model how coordination, cooperation and cancer risk control knowledge and expertise across Canada will save lives, reduce suffering and add economic value. The analytical tool used to formulate the strategy is based on the Life at Cancer Risk™ framework developed by RiskAnalytica. This framework incorporates, principles of physics, system theory and risk management; it is designed to measure and forecast the possible effects of cancer risk on a population and the way in which the effects of cancer can be mitigated through cancer control. Resulted in the Canadian Partnership Against Cancer Potential Lifestyle Changes : Diet, exercise, smoking, alcohol, reduced sun exposure, stress
  • There is considerable opportunity for companies to make a tremendous difference when cancer strikes. The way employers respond can shape the way in which their employees and their communities see them, with payback in employee and customer loyalty, and corporate reputation. Employers need effective policies, programs, training, and practices to create the supportive environments that can minimize disability, encourage early return to work, and generate trust and loyalty among employees
  • Alain Sotto Business of Aging Summit 2012

    1. 1. Cancer Prevention Programs in the Workplace: The Next Corporate Standard Business of Aging Conference: Innovation Vignette Toronto, April 30, 2011 Dr. Alain Sotto, Hon B.Sc., MD, CCFP(E.M.), F.C.B.O.M. Chief Physician of Ontario Power Generation (OPG) and Occupational Medical Consultant for Toronto Transit Commission (TTC) /
    2. 2. OBJECTIVES• Review Canadian Cancer stats and costs• Why implement cancer screening in the workplace?• Are there any corporate cancer standards?• Summary of OPG & TTC Colon Cancer screening program• Sample of Colon Cancer workplace presentation
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    4. 4. Cancer in Canada for 2011• Cancer surpassed Heart Disease as leading cause of death after 2007• 4 most common cancers: Lung, Prostate, Breast, Colorectal account for over 50% of All cancers• In 2011:est. 177,800 new cases: 75,000 deaths in Canada• On average 487 diagnosed & 205 will die every DAY with cancer• Over 1 in 3 will get cancer & Over 1 in 4 Canadians will die from it• Cancer is still the biggest concern and yet only 41% of Canadians surveyed have gone for screening within the past year*• 36% of Canadians also report never having been tested for cancer*See *Sanofi-Aventis Healthcare Survey 2011 4
    5. 5. Cancer Matters to Canadian Workplaces!!!!• Cancer: 3rd highest cause of LTD & has longest duration of STD claims• Expensive: lost productivity, disability, benefit costs & Newer drugs $$$ $• Cost of Biologics per patient per year: $1,000 – $70,000 !• E.G. Avastin, Tarceva, Gleevac, Sutent, Tykerb etc..• Canada ranks 13 out of 14 western countries for new Cancer treatments• Ontario spends 46% of total budget on health care !!!• Studies show 60 - 80% of cancer patients want to eventually RTW• Estimated impact of cancer in Canada for next 30 years(2004 - 2033)1 – $543 B wage-based productivity costs to Canadian economy. – $199 B reduction in corporate profits. 51- Risk Analytica - Life at Cancer Risk (2004 – 2033)
    6. 6. Cancer Really Does Matter to Canadian Workplaces !!!• 78% of Canadian employees surveyed in 2008 identified CANCER as their biggest health risk; however, few know how to prevent it.2 – Just 45% identified smoking cessation; 38% named diet; 28% said exercise. – Cancer screening clinics @ work + Concern for Cancer was rated 1st out of the 5 conditions @ 8.4/ 10!! {Cancer(8.4), Heart disease(8), DM(7.3), Mental Illness (6.7),Obesity (6)}• 90% of Canadians believe their employer has a role to play in cancer prevention. 2• With simple lifestyle- changes over 40 % of cancers could prevented!!!! 2 – Sanofi Aventis Healthcare Survey (2008) 6
    7. 7. Why do Cancer Control Strategies in the Workplace??• Workplace programs are ideal for 17 million working Canadians • Reduce mortality, morbidity (via Primary and Secondary prevention) • Enhances morale, loyalty, employee Engagement + employer image ( i.e. OPG--Top 100 in Canada / TTC--Top 75 in GTA).• There is no integrated national worksite strategy for cancer control.• Cancer agencies + other public health programs promote prevention and screening, but don’t target workplaces ??• There are no workplace standards for cancer prevention / management.• No incentives / recognition for companies that ‘get it right’. ISO’s, ACE 7
    8. 8. Case Studies: Colon Cancer Screening Program at OPG &TTC• Colon cancer is the number 2 cancer killer in Canada• It is also 90 - 95% preventable!!• I Approached Sr. HR Directors & Executives of why we need to do this. (Done within HR: OPG Wellness & TTC Occupational Health dept.)• Basically:...ROI = 1.” if we can save one life- then it is the right thing to do”• Wellness Goal: 4 E’s—Educate + Empower + Engage + Enable employees with Knowledge Transfer on Colon Cancer Screening• Communication campaign - face to face presentations, posters, email messages, internal newsletters, brochures, video etc..• Engaged Union support & Executive advocacy roles—key!• Facilitate and improve access to Colonoscopy screening clinics 8
    9. 9. Colon Cancer Screening Program--TTC• Sr. HR Director, champion-- engaged Executive leadership team( top 6)• TTC Union President and EVP asked to sign letter of endorsement for program• Managers requested multiple face to face presentations to employees by Dr. Sotto - including shift workers• Communication: TTC Colon Cancer Screening brochure & Referral forms attached to pay stubs & Coupler (internal) newsletter articles:• Managers volunteered to be advocates/ ambassadors encouraging their staff to get screened via personal testimonials etc.. 9
    10. 10. Colon Cancer Screening Program--TTC• TTC Management were surprised by employee interest and uptake• Partnered with Colonoscopy clinics like Sunnybrook-WCH, North York Endoscopy & others Clinics• Colon cancer program was open to spouses and family members• Colonoscopy Referral forms sent with brochure and given at Dr. Sotto’s presentations & on TTC intranet website• TTC Colon Cancer Awareness DVD + Forms were sent to 13,000 – March 2010• Educational materials given in partnership with Colorectal Cancer Association of Canada ( Barry Stein 10
    11. 11. Colon Cancer Screening Program--OPG• V.P. with colon cancer presented his story & I presented the medical• Communication strategy: 12,000 email messages with brief 3-5 minute video on importance of colon cancer screening, Newsletter, Wellness intranet, Face to face presentations, Video with Darryl Sittler- advocate• Very successful program!!!• Brief videos sent to ALL employees by email with message on Breast, Prostate, Colon cancers• Able to see how ees’ many watched video i.e.. over 5000 hits in 3-4 weeks for each video 11
    12. 12. Colorectal Cancer 2011 -- The Number 2 Cancer Killer!• 22, 200 Canadians Diagnosed: 12,500 Men + 9,700 Women• 9,100 Canadians will die of it: 5,000 Men + 4,100 Women• Accounts for 12% of all new cancer cases and 12 % of all cancer deaths• 61 Diagnosed every Day!!• 24 will Die every Day!!• Life-Time Risk of Developing Colorectal Cancer (CRC) • Men: 1/13 (7.7%) • Women: 1/16 ( 6.25%) • 1/ 28 for M & 1/ 32 F will Die *Canadian Cancer Society, 2011• 5- year Survival is 63% M & 64% F 12
    13. 13. Audrey Hepburn( 1929-1993)
    14. 14. Happy 50 th Birthday !!!!!!!!!! Women MenMammogram PSA + DREBreast Exam FOBT PAP Colonoscopy FOBTColonoscopy
    15. 15. N e w C a s e s o f C o lo r e c t a l C a nc e rRate per 100,000 500 400 300 200 100 0 20-24 30-34 40-44 50-54 60-64 70-74 80-84 Age
    16. 16. What are the symptoms of Colon Cancer ? • Most often, NONE!! It is silent but deadly!! • Usual symptoms: • Rectal bleeding • Anemia • Abdominal discomfort • Change in bowel habit • Unexplained Wt. loss You are at Average Risk, if > 50 and healthy! and You are at High Risk if Age >40: AND • If Family history of Polyps / Colon, Uterine, Ovarian, or Inherited Breast Cancers • If has Ulcerative or Crohn’s colitis 16
    17. 17. Colon Cancer• 95% colon cancers develop from Adenomatous polyps, which grow slowly, usually over a period of 10-15 years!!.• 2/3 of polyps are Adenomas which are pre-cancerous &• 1/3 are Hyperplastic (i.e. Low risk for Cancer)• Screening tests play a key role in detecting and removing polyps before they become cancerous• Diagnosis of Early stage colorectal cancer--- improves your 5 yr- survival to 90 % 17
    18. 18. W o r k p la c e S c r e e n in g is Id e a l:• Doing the screening testrwhen: n t i o n ! ! ! ! N o w Th a t’ s P e ve Everything works well & Feeling fine!! No complicating problems!! Employees are usually at Work—so can prevent disability & reduce costs! SCREENING SAVES LIVES!!
    19. 19. P o ly p in t h eC o lo n
    20. 20. How Common Are Polyps?50%30%10% 50 60 70 80 Age (yr) 20
    21. 21. COLONOSCOPY• For Average risk > 50 years old:1st FOBT and then Colonoscopy if blood (MOH)• If High risk : age > 40 or 10 years earlier than the age of 1st degree relative’s Dx of Colon cancer-whichever is first!• Checks for polyps + any abnormalities of ENTIRE large bowel/ colon• Invasive; under mild sedation• Needs bowel prep –KLEEN-PREP/ PICO-SALX• “Gold standard” for finding Colon Cancer and Polyps 21
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    23. 23. Katie Couric Effect: 20% increase in Colonoscopy rate 23
    24. 24. Sunnybrook & Women’s College Health Sciences Centre In Partnership with TTCPhysician Referral FormFor Colon Cancer Screening ProgramPatient last name: Patient first name: D.O.B:Address: City: Postal Code:Home Phone: Work Phone: Cell Phone: Health Card Number:Referring Physician: Referring Physician #:Reason for Referral:□ Screening Colonoscopy: If your patient is 50 years old or older and has no bowel symptoms. (This requires a screening colonoscopy as per the Canadian Association of Gastroenterology).Relevant Past Medical History:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Medications: Physician Name:___________________________________________________________________________ Physician’s Signature:___________________________ Date: _____________________________________________________________________________________ Stamp:____________________________________________________________________________________________________________________________________________________________________________ 24
    25. 25. Colon Cancer and Wine: Red or White?Does drinking red wine reduce your risk of Colon Cancer?• >3 g/ week of red wine reduced the incidence of colon cancer by 67%!!!!!!• Colon Cancer Rates: 9.9% Abstainers;8.8% White wine;3.4% Red wine• Red wine has the more Resveratrol
    26. 26. Colon Cancer : Fish & Calcium/ Vit. DA: Does eating fish 5X’s / week reduce your risk of Colon Cancer?(Harvard PH)• Men who ate fish >5 X’s / week reduced risk of Colon Cancer by 40%!B:Does Calcium and Vit D reduce the risk of Colon CA?• >800 mg of Calcium /day reduced it by 26- 46%• Vit D 1000 IU per day
    27. 27. SUMMARY: Key Points and ACTIONS for ALL!• Cancer affects All employers: STD/ LTD, Drugs & Benefits, etc.• CDN. employees believe their employer has role in prevention- 90%• Prevention programs are well received in workplace & at low cost!• Cancer screening advocates very helpful! e.g. Darryl Sittler• Check: – Online Cancer assessment tool• Need executive endorsement for workplace programs• Need corporate cancer Tool-kits for Managers• Need a Corporate Cancer Prevention Standard:• Check Ontario site:• Check CCAC:• Watch my Colon cancer DVD: Just do it!!!!!!!!!!!!!!!!!!!!!!!
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