Colorectal Cancer Canada - Less is more

Greg Thomson, Kate Bahen

July 4, 2017: Great news. A new charity, Colorectal Cancer Canada, is formed through the merger of two small charities Colon Cancer Canada and Colorectal Cancer Association of Canada. Canada’s very fragmented cancer charity space just got a bit less so. At last count, Canada has more than 278 cancer charities. Charity Intelligence has seen significant areas of overlap in activities of many of these charities. This merger has natural fit with both charities working on the same cancer with similar activities. Colon Cancer Canada and Colorectal Cancer Association both focus on public awareness, advocacy for screening, and providing support for Canadians with colorectal cancer. This merger is a great example for other charities to consider. When it comes to donor dollars being used most efficiently, duplication in efforts needs to be eliminated.

This is the second cancer charity merger in the last 12 months. The merger between Canadian Breast Cancer Foundation and Canadian Cancer Society announced in October 2016 is a mega-merger, 100 times bigger than this merger. Combining Colon Cancer Canada’s $1.1 million in annual donations and Colorectal Cancer Association of Canada’s $0.9 million from donations and special fundraising events will create a charity with about $2 million in total size. The combined Canadian Cancer Society and Canadian Breast Cancer Foundation will be an estimated $209 million.

Both Colon Cancer Canada and Colorectal Cancer Association are relatively new charities, founded in 1996 and 1998, respectively, and run by people affected by colon cancer. Colon Cancer Canada was founded by Bunny Schwartz who lost both her sister and husband to colon cancer, both of whom were only 46 years old. Colon Cancer Canada was co-founded with Amy Elmaleh, who lost her mother, Bunny’s sister. This aunt-niece combination built Canada’s largest colon cancer charity. Similarly, Colorectal Cancer Association was founded in 1998 by Barry Stein, a Stage 4 metastasis colon cancer survivor. Stein becomes the new charity’s President and CEO. This personal experience focuses charities on impact and filling the gaps.

What Colorectal Cancer Canada may look like

Going forward, Colorectal Cancer Canada intends to balance its budget, reversing yearly deficits. On a pro-forma basis, it had a significant deficit of $120,182 in 2014 and a $17,757 deficit in 2015. Colon Cancer Canada brings more cash;  the combined funding reserves will be $807,311, covering just over half a year’s program costs, indicating a need for funding. With Colorectal Cancer Association’s greater cost efficiency, the amalgamated charity will be within what Charity Intelligence deems a reasonable range with 69 cents of every dollar donated going to the cause.

Research grants will likely be curtailed or discontinued. With amalgamation, all previous donor funding commitments will be honoured. Colon Cancer Canada had previously spent 16% of its operating budget on research grants. With donations dropping in 2015, research grants were 8% of program spending. Going forward, research grants is likely not an area where Colorectal Cancer Canada sees the highest impact. Cancer research is very expensive for smaller charities. While cancer research is a popular area for giving, donors should recognize that, with colorectal cancer, more research isn’t the most pressing need. The greatest way to save the most lives is promoting early screening.

Charity Intelligence hopes Colorectal Cancer Canada will have full financial transparency, posting its audited financial statements on its website, and reporting to donors its progress in annual reports. With this, Colorectal Cancer Canada would be highly-rated and one of the top-rated cancer charities in Canada. Charity Intelligence will be reporting on Colorectal Cancer Canada in the future.

Canada’s “shockingly low” colorectal screening rate kills an estimated 2,050 Canadians a year

Hopefully, as one voice, Colorectal Cancer Canada (CCC) can be a louder advocate for colorectal screening. Canada’s low screening rates lead to an estimated 2,050 preventable deaths each year.

Early colorectal screening saves lives. Survival rates for colorectal cancer are 80%-95% for Stage I colorectal cancer, dropping to 55%-80% for Stage II. Since most Canadians don’t get screened, only 40% of colorectal cancers are found in these early stages.

One of CCC’s top priorities is getting Canada’s screening rate to 60%-70% for people over the age of 50. Ontario currently has the highest provincial screening rates at only 35%-40% and, no surprise, the highest survival rates at 67%. For context, screening rates average 58% in the UK, which Bowel Cancer UK calls “shockingly low”¹. Canada’s current screening rates are below “shockingly low”.

As mammograms led to lower breast cancer deaths, scientists estimate colonoscopies and fecal occult blood tests could reduce colorectal cancers by 33%-90%. For every 1% pickup in screening rates, colorectal deaths are estimated to drop by 3%.

Colorectal cancer is Canada’s second most diagnosed cancer (13% of annual cancer diagnoses²) and second deadliest cancer, accounting for 12% of all cancer deaths. The 5-year survival rate for colorectal cancer improved from 55% to 64% from 1994 to 2008, the most recent reported figures. In 2017, an estimated 9,400 Canadians will die of colorectal cancer.

Donate to the "Under-Funded Four" cancers: lung, colorectal, stomach, and pancreatic

Colorectal cancer is one of Canada’s “Under-funded Four” cancers along with pancreatic, stomach, and lung relative to their deadly impact on Canadians³. These Under-funded Four cancers account for 46% of potential years of life lost to cancer in Canada. Donating to these cancers is where donors have the best opportunity for real impact by filling a tragic funding gap. In Canada, 94% of cancer donations fund breast cancer, children’s cancers, leukemia and prostate cancer. The Under-funded Four cancers receive only 1.6% of donations. Breast cancer receives $691 in donations per “potential years of life lost” whereas the Under-funded Four receive only $5 in donations. While cancer giving is very personal, Charity Intelligence hopes donors start giving in terms of lives taken, rather than survivors.

Recently an alarming trend in colorectal cancer has emerged. Rates of colorectal cancer are steadily rising among Millennials and Generation X (born after 1980). Scouring through cancer records from 1981 to 2010, Dr. Prithwish De at Cancer Care Ontario found rates of colorectal cancer rose 6.7% in people aged 15-29⁴. Similar patterns are seen in the US with rising incidence rates in colorectal cancer among adults younger than 50⁵. These reasons remain unknown.

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Sources:

1. Bowel Cancer UK “Delay introducing new screening test” https://www.bowelcanceruk.org.uk/media-centre/news-and-blog/delay-in-introduction-of-new-screening-test-is-putting-lives-at-risk/

2. Canadian Cancer Statistics 2017 p.25.  http://www.cancer.ca/~/media/cancer.ca/CW/cancer%20information/cancer%20101/Canadian%20cancer%20statistics/Canadian-Cancer-Statistics-2017-EN.pdf?la=en

3. Charity Intelligence Canada, “Cancer in Canada” April 2011 https://www.charityintelligence.ca/cancer-in-canada

4. Carmen Chai, “Why are colon cancer rates in Gen Xers and Millennials in Canada rising?” Global News March 2, 2017 http://globalnews.ca/news/3283310/why-are-colon-cancer-rates-in-gen-xers-and-millennials-in-canada-rising/

5.   Canadian Cancer Statistics 2017 p.25. ibid.