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| Canada's child cancer shame | |
By RONALD BARR AND MARK GREENBERG Wednesday, July 16, 2003 - Page A15 |
|
About 1,300
children and teenagers are diagnosed with cancer
in Canada each year -- the commonest cause of
disease-related death in our children.
Happily, 70 per cent of those children will be cured and, with continued research, by the year 2010, as many as 85 per cent of such victims will be cured. So why is our federal government gutting research funding into childhood cancer? Canada's national contribution to improving the lives of children with cancer began in 1995 when the Canadian Childhood Cancer Surveillance and Control Program began operating under the direction of Health Canada's cancer bureau. From the beginning, this program, which has been overseen by a committee drawn from children's cancer centres across the country, as well as Health Canada, has had four main research components. The first focuses on the causes of childhood cancer. It aims to establish a national data bank of childhood cancer cases matched with detailed information on possible risk factors. The second moves to create a network of tissue banks to collect and store tissue from newly diagnosed children, as well as blood samples from their parents, to allow analysis of possible links between genetic characteristics of the cancers and the families affected. The third research component establishes a clinical database that includes information on demographics, type and extent of the cancer, treatment and outcome. The fourth, a continuing study of "late effects," is designed to assess the long-term psychosocial and physical effects of cancer and its treatment on children, adolescents, and young adults who have survived at least five years from diagnosis. Some such "late effects" are known to occur in most cancer survivors. This ambitious research program has proven successful, as evidenced by the sharing of new knowledge at numerous national and international conferences and the preparation of reports for publication in reputable medical journals. Despite its stated support for the program, the federal government has progressively shrunk the amount of funding it provides to collect vital information across the country. What began as a collection budget of $1-million a year has been reduced now to zero. This has meant that the research mandate has had to be scaled back significantly. Research into causes of childhood cancer has been restricted to two provinces (Quebec and British Columbia) and two diseases (leukemia and brain tumours) rather than looking broadly at evidence from across Canada. As well, the intended network of tissue banks has never been established (despite a pilot study demonstrating that it was both feasible and cost effective). The "late effects" study of cancer survivors has so far collected information on more than 2,000 Canadian survivors, but the continuing acquisition of information has had to be halted, ending ongoing evaluation of these important health hazards. With the original funding, research priority was given to the establishment of the clinical database for the surveillance of treatment and outcomes. This is potentially the richest and most informative source of information on cancer in Canada's children and youth; a resource unique to this country that will lead to advances in care and changes in health policy. It has already generated a wide-ranging report on more than 5,000 children that is near completion. Now, however, the lack of funding means the collection of this information is also stalled, threatening even this program. The Canadian Council of Pediatric Hematology-Oncology Directors (a consortium of leaders of all of the childhood cancer treatment centres across the country) has expressed its concern at the increasing threat to the survival of this program and has encouraged Health Canada to restore adequate financial support. Everyone, it seems, agrees this is a program worth saving. Health Minister Anne McLellan lauded the program last fall. An external appraisal recommended an annual operating budget of $1.5-million. In 1999, Canada's auditor-general expressed his support for the program. It also has the unqualified support of one of the groups most affected by its research: the parents of children with cancer. Despite all this, however, little material support has been forthcoming from the federal government. At a time when an international survey ranked Canadian scientists first overall in terms of impact on cancer, it is a national scandal that Health Canada seems prepared to allow this childhood cancer research initiative to fade into oblivion. Dr. Ronald Barr, professor of pediatrics,
pathology and medicine at McMaster University, and
Dr. Mark Greenberg, professor of pediatrics and
surgery at University of Toronto, are co-chairs of
the Canadian Childhood Cancer Surveillance and
Control Program. |
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