Pan-Canadian standards for rectal cancer surgery

March 29, 2019

These standards support the delivery of consistent, high-quality care for Canadians with rectal cancer who need surgery

These rectal cancer standards were created as a decision-making resource to support the delivery of consistent, high-quality care for all Canadians with rectal cancer who need surgery.

This document gives high-level guidance and discussion about foundational resources and requirements that are needed to improve surgical care for rectal cancer and its outcomes. Our goal is that the document’s actionable recommendations will help address current gaps, be used in the future and improve the delivery of rectal cancer surgical care.

These standards have been informed by environmental scans, a literature review and evidence-informed expert consensus. The document emphasizes key areas, like the Royal College of Physicians and Surgeons of Canada’s (RCPSC) system for evaluation and certified training. Other areas include systems of care and devoting a significant portion of competency to the practice and maintenance of rectal cancer.

Optimal rectal cancer care requires more than the rectal cancer surgeon. The supporting health-care team should be well-trained and adequately resourced to provide timely access to care. Also, there’s a heavy reliance on regions and institutions for coordinating diagnostic imaging, surgery, radiotherapy, chemotherapy, pathology and other ancillary recovery and survivorship services. As a result, rectal cancer surgeons must successfully collaborate with different levels of care to implement any standard.

The document also highlights the importance of advanced human-resource support, allied health professionals and both comprehensive and systematic resource planning to meet care targets.

Health-care planners and providers can use this document’s information to organize patients’ care in a way that maximizes outcomes while maintaining reasonable access to care.

Recommendations

Recommendations from the document include:

• Use quality processes, like collecting routine data and populating a national database, to help with evaluation and continuous improvement.
• Carefully consider regionalized and specialized services for patients with complex rectal cancer to improve their outcomes while giving them choices and accounting for their travel time.

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