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Cancer Care Program - Staff and Physicians

Cancer Risk and Prevention Potential

About half of all cancers are caused by factors that can be prevented (GBD 2019 Cancer Risk Factors Collaborators 2022). Effective cancer control can thus benefit from combining both health care-based and preventive measures, where cancer prevention offers the most feasible, cost-effective and sustainable pathway towards global cancer control.

The Canadian Population Attributable Risk of Cancer (ComPARe) study reports on the number and percentage of cancer cases in Canada in 2015 resulting from modifiable risk factors. 

It further estimates the impact of prevention interventions on future cancer incidence.

Several cancers can be prevented through healthy living and policies that protect the health of Nova Scotians. Many of the risk factors for cancer are also risk factors for other chronic diseases. Reducing cancer risk therefore reduces the risk of other chronic illness.

Canadian Centre on Substance Use and Addiction reports that the overall economic cost of substance use in Canada in 2020 was $49.1 billion. This works out to $1,291 per person in the country. Over 62% of the total costs are from alcohol and tobacco alone.

The Role of Healthy Public Policy

The Role of Healthy Public Policy in Cancer Prevention

Policies that create supportive environments, and make the healthy choice the easy choice, are more effective than individual or program approaches in improving population health. Policies have greater reach and offer a better chance of sustained change. Policy can impact multiple settings where we live, learn, work and play. The Canadian Partnership Against Cancer has developed a series of Prevention Policy Packs to guide evidence-informed decision-making in relation to cancer prevention policies.

Visit Cancer Prevention Policy Packs -- Canadian Partnership Against Cancer to access policy packs on the following topics:

  • Healthy Eating and Cancer in Canada  
  • Physical Activity and Cancer in Canada
  • Alcohol Policy and Cancer in Canada
  • HPV Immunization for the Prevention of Cervical Cancer
  • Commercial Tobacco 
  • Ultraviolet Radiation

An Equity Perspective

An Equity Perspective in Cancer Prevention and Health Promotion

Being able to identify, measure and map socio-economic status (SES) across communities is a critical step towards achieving greater health equity. This is particularly important in Nova Scotia, where both the rates of several cancers and prevalence of known risk factors are generally greater than those found elsewhere in Canada.

The Nova Scotia Community Socio-Economic Status (SES) Snapshot reports were developed in the context of the Nova Scotia Community Cancer Matrix (NSCCM), a research project funded by Research Nova Scotia and led by Dr. Nathalie Saint-Jacques, senior epidemiologist with the Nova Scotia Health Cancer Care Program.

These reports provide a window on the SES profile of communities included in each of the 37 Nova Scotia Health Community Health Boards (CHBs) distributed over four Health Management Zones. Some of the CHBs cross more than one zone, resulting in a total of 42 reports. The work reports on 301 communities, 23 cancer types and 99,000 cancer cases diagnosed over the period of 2001-2017.

The Dalhousie University Health Populations Institute is a multi-faculty research institute that aims to improve population health and health equity in Atlantic Canada. Learn more:

Cancers with Modifiable Risk Factors

Cancers with Modifiable Risk Factors

Cancer Care Program public subject guide: Preventing Cancer page

A series of infographics developed from the NS-Matrix presents information about the top 10 preventable cancers in Nova Scotia, including key risk factors, statistics, and steps to reduce modifiable risk.

Additional Resources:

UV and Skin Cancer Risk

UV and Skin Cancer Risk

Between 1984 and 2017, the incidence rate for melanoma in Canada increased an average of:

  • 2.2% per year in males
  • 1.4% per year in females

In Canadians aged 30 to 49 years, melanoma is the third most commonly diagnosed cancer, after thyroid and colorectal cancer.  

Exposure to ultraviolet (UV) radiation through sunlight, tanning beds and sun lamps is a well-established risk factor for melanoma.  (Canadian Cancer Statistics Advisory Committee et al., 2021)

It is anticipated that there will be a total of 410 cases of melanoma skin cancer diagnosed in Nova Scotia in 2022:

  • 230 in males
  • 180 in females

(Brenner et al., 2022)

UV radiation from the sun is also the primary cause of:

  • Basal cell skin cancer
    • Risk in adulthood increases with frequent, severe sunburns and intense sun exposure in childhood.
  • Squamous cell skin cancer
    • The main cause is chronic exposure to UV radiation from the sun or tanning beds.
  • Actinic keratosis
    • This is a precancerous condition. It can develop into squamous cell skin cancer if not treated.

 

Sun Safety in Nova Scotia - Where We Live, Learn, Work and Play

The Nova Scotia Cancer Care Program coordinates the Sun Safe Nova Scotia coalition, a network of agencies and individuals working collaboratively to support skin cancer prevention and risk reduction. The coalition takes a population health approach. Working with partners, they support policy and programming that encourages sun safety behaviour in priority settings.

 

Applying an Evidence-based Policy Approach to Sun Safety in Nova Scotia 

1.    Adopt sun protection policies to enable sun protective behaviour in:

  • School and childcare settings
  • Outdoor recreation and tourist settings
  • Outdoor work environments

In the School Setting:

SunSense is a national sun safety program developed by the Canadian Cancer Society. The program supports Canadian elementary schools to create a sun safe environment that protects students and staff from harmful ultraviolet radiation.

Schools can become SunSense Certified by completing a five-step process. To learn more, view the SunSense Program Guide.

Nova Scotia's Department of Education and Early Childhood Development provides requirements for protection from the sun as appropriate for the UV Index conditions.
Regulated Child Care Settings:  Section F:  Ministerial Requirements for the Daily Program 
Section 7.0 Environmental Conditions Definitions (ednet.ns.ca)

In the Outdoor Recreation and Tourism Setting:

Reduce the risk of overexposure to the sun for staff and participants in day camps, overnight camps, parks, sports clubs and community public spaces by adopting summer sun safety policy and programs. Tools and resources are available to assist with the development, implementation and evaluation of policy, staff training, participant engagement and promotion. Sun Safe Play…Everyday!  It Just Makes Sense.

In the Workplace:

Outdoor workers are at risk of:

  • Skin cancer (up to a 3.5 times greater risk than indoor workers)
  • Eye damage from long-term exposure to the sun
  • Heat stress

The good news is that these risks are preventable.

Sun Safety at Work Canada (SSAWC) enhances sun safety for Canadian workplaces. Applying sun safety at workplaces can be challenging. SSAWC:

  • Raises awareness of the importance of sun safety
  • Helps workplaces implement sun safety programs within their occupational health and safety management systems

The SSAWC project was funded by Health Canada through the Canadian Partnership Against Cancer. Funding for the ongoing maintenance of this website was provided by the Alberta Ministry of Labour and Immigration.

 

2.     Adopt policies that ban the use and/or sale of commercial UV tanning beds. The Nova Scotia Tanning Beds Act was passed in 2010. This legislation bans access to UV indoor tanning services to anyone under the age of 19.

Sun Safety Resources

Use these policy templates as a starting place for the creation of your own policy. Please add additional procedures that you would like to implement or remove procedures that you cannot commit to at this time. We encourage you to re-visit your policy each year and make any necessary updates.

If you have a policy and procedures in place, or currently have specific expectations on the topic of sun safety, make sure they are linked to the activities.

Sun Safe Nova Scotia

  • Policy and procedure templates for recreation and sport organizations are available. Request a template:

SunSmart Saskatchewan 

High Five and Sun Safety 

SunSafe Nova Scotia has partnered with High Five Nova Scotia to promote sun safety as an integral component of quality recreation and sport programming during the summer months. Resources include: 

Use activities, crafts and songs to solidify sun safety messaging among program participants. Summer staff may wish to commit to doing one activity each week as part of their program plans. Try these activities:

Videos

Songs can be a great way to make sun safety fun. Staff may choose to teach one of these songs to their participants and sing it while applying sunscreen.

Promotional Resources

These resources can help you communicate the importance of sun safety to parents, staff, volunteers, and program participants. Be creative with these promotional tools.

Educational Resources

Alcohol and Cancer Risk

The Canadian Centre on Substance Use and Addiction (CCSA) has released updated Canadian guidance on alcohol and health.

The report indicates that alcohol is linked to several types of cancer, including cancers of the:

 

Alcohol Risks and Harms for Nova Scotians

Cancer Care and Mental Health and Addictions, in coordination with other health system partners, including IWK Health, the Nova Scotia Department of Health and Wellness, and Nova Scotia Health Public Health, developed an FAQ with information specific to alcohol use in Nova Scotia.

The updated guidance reflects current evidence on alcohol and cancer risk. It is important for people to understand this information, so they can make informed decisions. It will also inform the health system as it strives to support the health of Nova Scotians.

Nova Scotia Health is committed to improving knowledge of the risks and harms associated with alcohol use, and will work with our partners to reinforce the following points:

  • Alcohol is one of the leading preventable causes of death, disease and disability worldwide. Alcohol use is a contributing cause of more than 200 diseases and health conditions, including seven types of cancer. 
    • Alcohol causes nearly 7,000 cancer deaths each year in Canada.
    • In 2020, 4.1% of all new cases of cancer globally were attributable to alcohol consumption.
  •  Nova Scotia has a culture of alcohol consumption that sees residents drinking more alcohol, and more heavily, than most Canadians. 
  • Nova Scotians have a right to know the health risks associated with drinking alcohol. By supporting people to make informed decisions, governments and health system leaders can improve long-term population health. 
  • Evidence shows that drinking alcohol always has some risk. How much and how often a person drinks has impacts on their health. The health risks increase with each additional drink and with frequency of consumption.
  • The risk for alcohol-related harms is strongly influenced by factors in our social, economic and physical environments. These factors can include:
    • The accessibility and affordability of alcohol
    • Social and cultural norms around drinking
    • Coping with loss of cultural identity, racism, stigma and discrimination
    • Economic resources

Understanding and taking steps to address social determinants of alcohol-related harms requires our combined efforts. To learn more:

Tobacco and Cancer Risk

Tobacco smoke is classified by the International Agency for Research on Cancer (IARC) as a Group 1 carcinogen. Tobacco smoke contains over 4,000 different chemicals, at least 70 of which are carcinogenic.

Use of commercial tobacco increases the risk of many types of cancer including:

  • Ovarian 
  • Kidney 

30% of all cancer deaths and up to 85% of lung cancer cases are caused by smoking commercial tobacco. The evidence supports a causal link between second-hand smoke exposure and lung cancer.

The Canadian Centre on Substance Use and Addiction reports that the overall economic cost of substance use in Canada in 2020 was $49.1 billion dollars. Over 62% of the total costs are from alcohol and tobacco. This reflects costs due to health care, criminal justice, lost productivity and other direct costs. In Nova Scotia, the cost in 2020 was $1.4 billion dollars or $1,494 per person, regardless of age. The cost for tobacco alone in Nova Scotia in 2020 was $445 million dollars.

Reducing smoking prevalence is a priority in cancer and chronic disease prevention. Comprehensive, multi-component and multi-level strategies have enabled significant reductions in tobacco use in Nova Scotia and across Canada. Nova Scotia continues, however, to have one of the highest rates of smoking in Canada at 13.7% compared to the national rate of 10.3%.

Applying an Evidence-based Policy Approach to Tobacco Control in Nova Scotia

  1. Protect People from Tobacco Smoke
  • To report a complaint or evidence of non-compliance of the Tobacco Access Act or the Smoke-free Places Act, contact the Department of Environment:
    • Phone (toll-free): 1-877-936-8476
  1. Offer Help to Quit Tobacco Use

Tobacco cessation supports are accessible throughout Nova Scotia including:

Cessation Aids/Options in Nova Scotia

The Non-Insured Health Benefits program provides eligible First Nations and Inuit with coverage for a range of health benefits, including prescription drugs and over-the-counter medications. This includes cessation aids like Nicotine Replacement Therapy, bupropion and varenicline.

  1. Warn About the Dangers of Tobacco Use

Healthy Eating and Cancer Prevention

Health-promoting diets, including adequate fruits and vegetables, reduce the risk of several cancers, including:

  • Prostate 
  • Diet accounts for about 10% of all cancer cases in Canada.
  • Only 18% of Nova Scotians over the age of 12 consume 5 or more servings of fruits and/or vegetables daily.  
  • Nova Scotia experienced the highest rate of food insecurity in both 2018 and 2019 when compared to the other Canadian provinces.
  • In 2021, Statistics Canada reported the moderate to severe food insecurity rate was 16.9%.

Applying an Evidence-based Policy Approach to Healthy Eating in Nova Scotia

Public Information

Physical Activity and Cancer Prevention

Being physically activity can reduce the risk of several cancers, including:

  • Kidney 
 
  • Following physical activity guidelines could reduce cancer risk by 10 to 25%.

Applying an Evidence-based Policy Approach to Physical Activity and Cancer Risk in Nova Scotia

Information, Resources and Programs

Canadian Cancer Statistics Advisory Committee in collaboration with the Canadian Cancer Society, Statistics Canada and the Public Health Agency of Canada. (2021). Canadian Cancer Statistics 2021. Canadian Cancer Society. https://cdn.cancer.ca/-/media/files/research/cancer-statistics/2021-statistics/2021-pdf-en-final.pdf

Brenner DR, Poirier A, Woods RR, Ellison LF, Billette JM, Zhang SX, Yao C, Finley C, Fitzgerald N, Saint-Jacques N, Shack L, Turner D, Holmes E, for the Canadian Cancer Statistics Advisory Committee. Projected estimates of cancer in Canada in 2022. CMAJ 194(17); E601-7. https://doi.org/10.1503/cmaj.212097