Healthy Outcomes Conference, Whistler, BC March 31 April 2, 2009 Cancer Control in the Workplace: A Corporate Standard Dr. Alain Sotto, Hon.BSc, MD, CCFP(EM), FCBOM Chief Physician, Ontario Power Generation (OPG) and Occupational Medical Consultant, Toronto Transit Commission (TTC) alain.sotto@opg.com/alain.sotto@ttc.ca
Cancer matters to Canadian workplaces Cancer may soon surpass CVS disease as leading cause of death. For 2008:166,400 new cancers: 73,800 deaths in Canada About 1 out every 4 Canadians will die from cancer New cases: Men: Lung, Colorectal, Prostate Women: Lung, Colorectal, Breast Cancer is complex and emotionally charged!! 30% of all new cancers and 18% of cancer deaths occur in working age Canadians (20-59) Cancer incidence is rising in young women ages 20-39 2
Cancer matters to Canadian workplaces Cancer accounts for 3rd highest cause of LTD & for longest duration STD claims Increasingly expensive for employers :lost productivity, disability, higher drug, and benefit costs etc... Studies show 60-80% of cancer patients want / eventually RTW Estimated Impact of cancer in Canada (2004-2033) 1 $543 B wage-based productivity cost to Canadian economy. $199 B reduction in corporate profits. 1- Risk Analytica - Life at Cancer Risk (2004 2033) 3
Cancer matters to Canadian workplaces 80% 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. 2 90% of Canadians believe their employer has a role to play in cancer prevention. 2 With simple lifestyle changes over 50% of cancer cases could be prevented! 2 Sanofi Aventis Healthcare Survey (2008) 4
Canada s Corporate Roundtable on Cancer Control Workplace programs are ideal for 17 million working Canadians Reduce mortality, morbidity (via primary and secondary prevention) Enhance morale, employee engagement and 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 and other public health programs promote prevention and screening, but do not target workplaces?? There are no workplace standards for cancer prevention or management, and no recognition for, or knowledge transfer from, companies that get it right. 5
Canada s Corporate Roundtable on Cancer Control Mission To develop, test, and implement a comprehensive workplace cancer standard and strategy that improves the understanding of how to control cancer through improved prevention, screening, support, and access. There will be 3-5 pilot sites testing different parts of the program model. CCRCC s workplace cancer control strategy will be officially launched in September 2009. 6
Canada s Corporate Roundtable on Cancer Control The A/C/E Standard The Checklist: Allows organizations to self-assess achievement and progress. Encourages progression through Accredited / Commendable / Exceptional ratings. Components: Checklist completion Prevention and screening Cancer education System navigation Social support Marketing Metrics Model policy adoption Completion of cancer risk survey Change in knowledge + awareness Number screened by cancer type Patients referred for navigation help Return to work rates 7
Case Study: Colon Cancer Screening Program at OPG &TTC Colon cancer is the number 2 killer in Canada & is 90-95% preventable! Approached Sr. HR Directors & Executives of why we need to do this. (Done within HR: OPG Wellness & TTC Occupational Health dept.) Basically:... if we can save one life, then it is the right thing to do (Cost was NOT the driver!) Communication campaign - face to face presentations, posters, email messages, internal newsletters, brochures, video etc.. Goal: To EMPOWER employees with Knowledge Transfer on Colon cancer Engage Union support & Executive advocacy roles key! Facilitate and improve access to Colonoscopy screening clinics 8
Colon Cancer Screening Program--TTC Sr. HR Director, champion-- engaged Executive leadership team( top 5) 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 form attached to pay stub & Coupler (internal) newsletter articles: video soon to be released Managers became advocates/ ambassadors for the program encouraging their staff to get screened via personal testimonials 9
Colon Cancer Screening Program--TTC TTC front line management were surprised by employee interest and uptake Partnered with Colonoscopy clinics like Sunnybrook-WCH, North York Endoscopy & others like Cancer Care Gastroenterologists Colon cancer program was open to spouses and family members Colonoscopy Referral form sent with brochure and given at Dr. Sotto s presentations and on TTC intranet website Educational materials given in partnership with Colorectal Cancer Association of Canada (www.ccac-accc.ca) 10
Colon Cancer Screening Program--OPG V.P. at OPG with colon cancer became personal ambassador sharing his personal story & Dr. Sotto would present the medical facts & science Communication strategy: 12,000 email messages with brief 3-5 minute video on importance of colon cancer screening, newsletter, Wellness intranet website, Face to face presentations, video with Darryl Sittler as advocate Very successful program: Brief videos-vignettes sent to ALL employees by email with message on Breast, Prostate, Colon cancers Able to see how many watched the video i.e.. over 5000 in 3-4 weeks 11
A Few Slides from Dr. Sotto s presentation: Canada 2007: Colon Cancer Stats 20, 800 Canadians Diagnosed 8700 Canadians will die of it 400 Diagnosed every week 167 will die every week!! Life-Time Risk of Developing Colorectal Cancer (CRC) Men: 1/14 (7.1%) Women: 1/16 (6.3%) 1/ 28-31 will Die( 3.2-3.5%) *Canadian Cancer Society, 2007 12
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 High Risk & Age >40: If Family history of Polyps or Colon, Uterine, Ovarian, or Inherited Breast cancers If has Ulcerative or Crohn s colitis 13
How Common are Polyps? 50% 30% 10% 50 60 70 80 Age (yr) 14
Colon Cancer 95% colon cancers develop from Adenomatous polyps, which grow slowly, usually over a period of 10-15 years!!. About 2/3 of polyps are Adenomas which are pre-cancerous & other 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 yrsurvival to 90 % 15
COLONOSCOPY For Avg. risk > 50 years old / If High risk- age >40: Checks for polyps + any abnormalities of ENTIRE large bowel/ colon Invasive; under mild sedation Needs bowel prep- PICO-SALX Gold standard for finding Colon Cancer and Polyps 16
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Katie Couric Effect: 20% increase in colonoscopy 18
Sunnybrook & Women s College Health Sciences Centre In Partnership with TTC Attention: Mr. Gil Valencia Fax: 416-323-6157 Phone: 416-323-6400 ext. 4240 or 416-323-6293 Physician Referral Form For Colon Cancer Screening Program Patient 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: 19