Colorectal cancer screening can be life-saving. But not everyone can access it.

A new initiative from the Canadian Cancer Society and MaRS aims to make screening more readily available to underserved communities.

Sonie Flores, a nurse in Winnipeg, is intimately familiar with the toll cancer exacts. She moved from Toronto 10 years ago to work at Winnipeg’s Mount Carmel Clinic, which serves a highly marginalized community where many people often can’t afford access to treatment. And then in 2018, Flores herself was diagnosed with colorectal cancer. She was rushed to hospital after losing consciousness in a washroom, and her doctors discovered the tumour.

Flores was stunned. As a healthcare provider she knew the symptoms to look for. “But it was stage three, which means it had spread to my lymph nodes,” she says. “I had to go through six months of chemotherapy.” She’s been back at work for more than a year, but it was a long journey to get there. Part of the side effects of the treatment caused her to lose sensation in her feet and hands, so she had to learn to walk again and use her opposite hand for work.

When Flores was diagnosed, she was one month shy of her 50th birthday, the age at which people become eligible for routine colorectal cancer screening. This screening is vital to catching the disease early, when survival rates can be as high as 90 percent, but socioeconomic barriers prevent many at-risk people from accessing care.

“We’re at a really challenging crossroads for healthcare,” says Sandra Krueckl, an executive vice president at the Canadian Cancer Society. “We really need improvements that address the state of our system.”

Canada’s healthcare system has long struggled with wait times and access to care, but COVID-19 has placed further strain on the system. Simply adding more capacity to solve the problem is like adding more lanes to a highway — it won’t fix the underlying issue. What’s needed is more efficiency. To help speed up the innovation process, the Canadian Cancer Society is partnering with MaRS to find tangible solutions.

Inequality in health care

Colorectal cancer is the fourth most commonly diagnosed cancer in Canada. This year, approximately 24,300 new cases will be diagnosed. Yet many cases go undiagnosed or undertreated. Flores points to privileges that helped her through her illness — like sick leave and secure housing — that remain out of reach for many in marginalized communities. And the rising cost of living and pandemic-caused delays is making it even more challenging. Flores is seeing patients forced to choose between their health and other necessities.

“For a colonoscopy test, you have to first prepare with a drink that costs $30. For my clients, that’s a lot of money. Then on the day of your test, you need someone to pick you up and you can’t drive for a day,” she says. “A lot of people don’t have that luxury.” For instance, one of Flores’ clients had to miss some of her chemotherapy appointments because it would make her too sick to look after her grandchild while her daughter worked. The client passed away in January.

“The people that I serve, they don’t have good paying jobs and — if they do have jobs — they don’t have benefits and cannot afford missing work for appointments,” Flores says. “The social determinants of health says that you don’t treat sickness as the illness — the illness is actually the social issues: a single mother who doesn’t have a child care option, a poor person who will have to choose a prescription or food, or people who need to solve their housing issue before their health.”

Call for innovative solutions

To help address these barriers to care, the Canadian Cancer Society and MaRS have announced a new innovation challenge.

“We’re looking for solutions that move the dial to improve access to screening and early detection to an even earlier stage in the process when the cancer doesn’t even have any symptoms or is precancerous,” Krueckl says. “We’re facing many delays in the system and we’re facing an overburdened system, so we need effective and efficient ways to engage people with the solutions that are out there that can help detect their cancers early.”

The challenge is zeroing in on key populations that struggle with accessing care, such as people with low income, recent immigrants and remote communities. Of course, that’s no easy task, which is why innovation challenges can be a powerful tool to not just spark new ideas for solving daunting problems but also accelerate the adoption of the solutions.

This new challenge builds on the success of one MaRS did last year in partnership with Merck for lung cancer diagnosis and treatment. Innovators were asked to send in submissions that are judged on issues such as impact, scalability, feasibility and sustainability. Finalists then presented their solutions before a winner was selected. Within four months, the Lung Cancer Innovation Challenge brought forward a number of compelling solutions, which demonstrates the effectiveness of the approach.

“An innovation challenge democratizes the innovation process, because innovation can come from anywhere and it’s a fair, transparent and open process,” says Alex Ryan, senior vice president of Partner Solutions at MaRS. “A normal procurement process really privileges incumbents with legacy solutions, often with decades-old technology. So you get shiny, nicely written proposals that are promises rather than solutions and they tend to be tried and tested rather than new and innovative.”

For MaRS, this innovation challenge aims to promote inclusive innovation. While successful solutions could save lives across the country by shortening wait times and increasing screening rates, they’ll have an outsized impact on marginalized communities. “We have a great healthcare system in Canada but it’s not equally accessible to everyone,” Ryan says. “This challenge will help those who are most vulnerable, most underserved and need help the most.”

As Flores says, everybody needs to be screened; we need to find ways to help those who can’t currently access care. “I really believe that if we can help them remove those barriers, then all of us will be winners,” she says.

Applications for Innovating for Everyone: Colorectal Cancer Early Detection Challenge are now open. Find out more here.