The Association des médecins hématologues et oncologues du Québec represents 350 members aged 47 on average. Recruitment for this specialty is booming, as the need for oncologists is increasing all the time. We have 55 residents and 22 fellows in medical subspecialties because we must deal with the aging of the Canadian population. As you know, it is expected that approximately one in two Canadians will develop cancer in their lifetime.
People studying in the field have clinical responsibility for the diagnosis and treatment of a variety of hematological diseases, both cancerous and non-cancerous, as well as for cancer care. These people practise mainly in hospital settings. Unlike our colleagues in English Canada, in Quebec, we are also responsible for laboratory operations. The people in that environment have to absorb an explosion of knowledge, which has major repercussions.
The pandemic has had an impact on cancer care because, as has been pointed out, the health system has been oversaturated and a lot of activity has been offloaded. In Quebec, for example, 100,000 people were waiting for colonoscopy before the pandemic, the test used to diagnose colon cancer. Now, over 150,000 people are waiting for this test. We therefore estimate that a significant number of cancer cases have not yet been diagnosed including about one in five cases of colon cancer.
To put things in perspective, a colon cancer screening program is expected to reduce mortality by approximately 20%. In Canada, in 2021, an estimated 28,400 Canadians have been diagnosed with colon cancer and 9,400 will die from it. If offloading has had a significant impact, it means that many more people will die. In addition, because of the delay in diagnosis, the diseases are more advanced and require more intensive therapies. This leads to more morbidity, more complications and more mortality in patients.
At present, we hear of waiting lists for orthopaedic surgery that have grown much longer. But unlike patients who undergo orthopaedic surgery, cancer patients are in the health system for years. So it is not a one-off investment that will solve the problem; it will be necessary to make investments over a long period. Staff shortages have already been alluded to. In some key areas such as pathology, it will be essential that staff are well supported so that oncology recovery capacity is not limited.
The pandemic has had other major impacts. Prior to the pandemic, a survey of Quebec hematologists and oncologists was conducted. More than 80% of them said they had the support and recognition of their colleagues. However, there was a high rate of burnout. Of the respondents, 11% reported depersonalization, 40% reported emotional exhaustion and 16.5% reported psychosomatic problems, giving an overall burnout rate of 57%. These statistics are from before the pandemic, and at that time people were still committed to the profession. We felt Mr. Coletto's passion during his speech. People are still passionate and they still find their work fulfilling.
However, we are very concerned that the pandemic has resulted in less physical contact with patients and colleagues, and this will likely have a significant impact on burnout for all health care workers. According to a study of 153 doctors in Quebec, their stress level is unprecedented, at 61% compared to 35% before the pandemic.
What are the solutions?
Diagnostic standards of treatment and supervision already exist in oncology. So we don't need new standards. But we do need resources. This means investing in health care to improve infrastructure, train staff and facilitate automation in laboratories. I think that the federal government will be able to increase its contribution to health care, not only on a one-time basis, but on a recurring basis to meet the needs in hematology and oncology.
The health care system must be focused on value, not just cost reduction, to maximize patient outcomes with the resources available. This means having an organized and integrated continuum of care. We need information systems. Currently, we are in the Stone Age. We still have systems that are difficult to consult and not complementary. We must therefore facilitate the integration of data through artificial intelligence.
This requires incentives, particularly financial incentives, aimed at aligning the objectives of health care institutions with value. This requires investments in artificial intelligence and computer networks.
In addition, we must facilitate access to the medical professions for new immigrants who are properly qualified to facilitate recruitment and integrate them into a process of onboarding and socialization.
Finally, I would like to highlight the distress of people working in the health sector. We must increase support for organizations that help professionals, such as the Québec Physicians' Health Program. I am referring to doctors, but this applies to all health sectors. We feel that this is essential to combat the psychological distress observed among health professionals.