Thank you very much. Thanks for the opportunity to be part of today's session.
I'm a surgeon, scientist and professor at UBC. I spend half of my time in surgery and seeing patients with gynecological cancers and half in translational research.
You have heard from my colleagues about the disparity of funding for gynecological cancers, and you will hear more. I'm extremely grateful to federally supported funding initiatives, such as the Canada research chairs, and institutions like CIHR, without which many of the discoveries you'll hear about today would not have been possible. However, the competition for research funding has soared, and actual funding available, particularly for multidisciplinary team projects and clinical trials, is increasingly difficult to obtain. We're at risk of losing our reputation in Canada of being innovative, creative leaders changing the landscape of gynecological cancer care. We're at risk of appearing irrelevant if the scientifically validated initiatives that we generate are not actually implemented and delivered to Canadians in a timely fashion.
I'm going to share one example of proven research advancement that was homegrown in Canada, an example of where we need to do better about ensuring equitable access for all Canadians.
Endometrial or uterine cancer is the most common gynecological cancer. Globally, it is increasing in both incidence and mortality, and it's on a trajectory to be the second most common cancer that women—including gender-diverse, trans and non-binary individuals—are likely to develop in their lifetimes. Despite these statistics, there has been little research, attention or funding related to endometrial cancer. It receives about a fifth of what prostate and breast cancer research receive.
Beginning about 10 years ago, we recognized that the way endometrial cancers were being categorized and subsequently managed was not working. There was little consensus between expert pathologists and their diagnostic reporting, meaning that a patient could get a completely different diagnosis from two different pathologists, directing them, for example, to six months of radiation or chemotherapy or to no treatment at all.
Clearly, this way of managing it was unacceptable. Our team worked to change this. We identified key molecular features in endometrial tumours that could be determined by simple methods that are achievable in most hospitals already. Within five years, we created a system that could consistently classify tumours and form molecular subtypes. They could identify which patients were most likely to have their disease recur and which patients were most likely to have an inherited cancer syndrome, and they could determine which treatments worked best.
Our classification system was adopted by the World Health Organization in 2020, and it was immediately implemented into international treatment guidelines. It is now considered the standard of care globally.
What is tremendously frustrating is that despite the international recognition, molecular classification is not uniformly available to patients across Canada. Even in British Columbia, where we developed this tool, it took two years for us to assure free testing for all endometrial cancer patients. In Canada, we have centres where they may actually have to wait eight to 10 weeks for their results. They may have to send their tissue out of province to get molecular testing. Molecular testing may never even be discussed with patients. Essentially, endometrial cancer has had one of the worst examples of health care inequities of any cancer. Our team is passionate about changing this.
My call to action is to first work to ensure that scientifically proven, value-added initiatives in prevention, diagnosis, screening and treatment of gynecological cancers are available to all Canadians. This could be by supporting provinces, for example, to fund molecular testing for endometrial cancers across Canada. We must change the current reality in this country that how you are treated depends on where you're diagnosed and must instead ensure equity for all.
Second, I call for increased funding for gynecological cancers, particularly funding for clinical trials and to support multidisciplinary team research, where it's been so successful in identifying important changes needed in clinical care. We've all witnessed what this government's rapid, impactful and successful communication actions could do in the recent COVID crisis. This proves that federal government initiatives on health communication are possible and can be effective.
I look forward to seeing what we can achieve in these initiatives for the prevention and treatment of gynecological cancers in Canada, and I commit to working hard with you to create these changes.
Thank you very much.