Preparing for the Recovery from the Effects of the PAndemic on cancer control using Real-world Evidence in Canada (PREPARE-Canada)

The global burden of cancer is a major public health crisis that has been deeply exacerbated by the COVID-19 pandemic. Since the World Health Organization declared COVID-19 a pandemic on March 11 2020, provinces across Canada have undergone varying degrees of cyclical lockdowns. Many provinces have canceled or delayed scheduled surgeries and ceased non-essential clinical activity, including essential cancer screening and care activities. As a result of missed screening appointments, many cancers will only be captured at a much later stage when treatments are less likely to be effective. The benefits of early detection are of paramount importance to outcomes at the patient level, and are associated with significantly less burden placed on the healthcare system which translates into economic benefits. The effects of the pandemic will be felt for many years and healthsystem capacity will remain under pressure due to the balancing act between COVID-19 care, disease incidence and a wave of demand stemming from delayed, and likely more severe, diagnostic outcomes and treatment requirements. To equip the healthcare system to plan for the future demand, it is essential that we capture the impact of COVID-19 on cancer outcomes in Canada, as well as the impact of COVID-19 on modifying cancer risk in the general population. Here, we will take advantage of the Canadian Partnership for Tomorrow's Health (CanPath), the largest population health study in Canada's history, to capture the effects of the pandemic on patterns of cancer diagnoses across Canada and access to services. We will study how the pandemic has impacted demand for cancer services at a population level and will also capture how COVID-19 infection changes cancer risk at the individual level. These insights will be used to predict the burden of cancer in the coming years which will directly inform the cancer control strategies in a post-pandemic Canada.