Good morning. I move that, in the opinion of this House, the government of Ontario should assess the Ontario lung cancer screening program to determine whether expansion is warranted and more sites are necessary to better serve Ontario patients and to look at broadening the eligibility criteria for access to the lung screening program.

This is a cause close to my heart because, as a nurse who still works at Etobicoke General Hospital, I see the devastating impact that lung cancer has on individuals and their families. A diagnosis is devastating. I know that our government is committed to increasing access to health care, but there’s always more work to be done.

Lung cancer impacts your ability to breath. As much as we can manage symptoms, there’s nothing worse that a patient can be going through than when their ability to breath is restricted. Speaker, 11,000 people across Ontario are diagnosed with lung cancer each and every year, with the average age being 44 years old to 50 years old. I wonder how many members fit in that range. That’s a pretty scary number, 44 years old to 50 years old. That’s the average age of diagnosis. And it is the most common cancer diagnosis in the country. It claims the lives of close to 7,000 Ontarian residents each year.

Most lung cancers are caused by tobacco smoking, with the more years you smoke, the greater the risk. This also includes exposure to second-hand smoke. The most recent data from 2020 shows that the smoking prevalence in Ontario is 9.9%, which is lower than the national average of 11.6%. That has been on a decline over the last several years, which is a good trend that we would like to see and support.

But let’s not forget that lung cancer is not always linked to smoking. Close to 15% of lung cancer patients never smoked, and 35% stopped smoking long before their diagnosis. Other causes include family history, previous radiation therapy, exposure to carcinogens such as asbestos or exposure to radon gas. This fact about radon gas is not one that is widely known by the Ontario public.

Speaker, Ontarians should know about radon gas and its dangers. It is an invisible and odourless radioactive gas that is naturally released by the breakdown of uranium in soil, rocks and water. It can get into homes and buildings through cracks and holes, and eventually build up to unsafe levels. There are many things Ontarians can do to protect themselves and their loved ones from radon gas. The first is to buy a testing kit at their local hardware store, and if levels are detected, they can seal cracks in their home’s foundation, use a heat recovery ventilator or allow for natural ventilation.

Speaker, I would also like to touch on the growing problem of vaping among our young people. As you know, my colleague the member for Kitchener South–Hespeler has done incredible work advocating for keeping vapes, tobacco and cannabis out of schools. In a way, both of our motions intersect on this vital issue. While vaping hasn’t been around long enough for scientists to conclusively know if vaping causes lung cancer, we do know that vapes contain dangerous chemicals that no child should ingest. These include, of course, nicotine, a highly addictive substance that negatively affects developing brains, and harmful carcinogens like formaldehyde. Another chemical found is diacetyl, which is linked to a lung disease known as “popcorn lung,” which is damage to the lung’s small airways. Speaker, while we don’t know if vaping causes lung cancer, there is a chance that it might, and keeping these devices out of kid’s hands could prevent a potential health crisis that we may not even see coming.

I also want to bring attention to asbestos, a carcinogen with a strong link to lung cancer and diseases such as mesothelioma and chronic pulmonary disease. It is a fibrous mineral that is known for its durability and heat resistance, and exposure is most commonly experienced by those who work in the manufacturing sector. Before 1990, it was commonly used to insulate apartment buildings and homes from cold weather and was used for fireproofing. Inhaling its tiny fibres is painless but can cause severe problems in the future. It takes decades after exposure, ranging from 10 to 40 years, to develop cancer, depending greatly on how long your exposure was.

In 2018, Canada banned the manufacturing, import, sale and use of asbestos; however, it is still our country’s leading cause of workplace death. Across Canada, nearly 2,000 cases of lung cancer are linked to asbestos exposure. Speaker, it is a myth that asbestos is a settled issue. There are still people in our communities who have been exposed prior to the ban, and it can be found in older buildings.

Avoir un cancer du poumon peut être une expérience très douloureuse et inconfortable. Il peut entraîner de nombreuses complications, telles qu’un essoufflement, des crachats de sang, des douleurs dans la région de la poitrine et la présence de liquide dans la poitrine, appelée épanchement pleural.

There are many things that Ontarians can do to reduce their risk of lung cancer, which includes, of course, avoiding tobacco, avoiding second-hand smoke, testing your home for radon gas and wearing a mask to avoid breathing in carcinogens in the workplace and keeping a healthy diet and active lifestyle.

This past November was Lung Cancer Awareness Month, and we had receptions from a number of incredible groups that advocate for this cause, such as the Canadian Cancer Survivor Network, the lung cancer foundation and Lung Cancer Canada, all united under one campaign entitled Right2Survive. I had the chance to meet cancer survivors whose stories of hardship and resilience inspired me to take action. And today, we also have a guest from the Canadian Cancer Society, Hillary, who has been a staunch advocate for putting this motion forward. These organizations work hard to advocate for both prevention and for Canadians living with lung cancer, and for that, I strongly commend their efforts and support.

Speaker, lung cancer is the leading cause of cancer death for people in Ontario. It kills more people than colon, breast and prostate cancers combined, because lung cancer is usually detected late, when symptoms can already be noticed. In Ontario, 70% of lung cancers are diagnosed at advanced stages, and as a result, survival rates are reduced. In fact, in Canada, five-year survival rates depend greatly on what stage the cancer was diagnosed. Those diagnosed at stage 1 have a five-year survival rate of 60%, but those diagnosed at stage 4 have only a 5% rate of survival. This is why early screening and increasing eligibility criteria are essential. And let’s not forget that lung cancer can spread to other body parts, including the brain and bones.

Speaker, let’s look at the facts. When you have earlier cancer detection, you have better treatment outcomes. This can only be done by expanding the eligibility criteria and the number of sites across Ontario.

Selon les critères d’admissibilité actuels de notre gouvernement, seules les personnes âgées de 55 à 74 ans qui sont des fumeurs quotidiens peuvent faire l’objet d’un dépistage. Or, il y a en Ontario des personnes qui n’ont jamais fumé de leur vie et qui finissent par contracter ce cancer du poumon, ce qui consiste d’une minorité.

Furthermore, while the Ontario Lung Screening Program currently operates in Oshawa, Sudbury, Ottawa and Toronto, there is no location in Peel region, a high-growth region home to 1.5 million residents. That is why I am calling on our Ministry of Health to assess this program and to determine if expansion is warranted and if eligibility should be broadened. Through screenings, we can change the lives of individuals and families across Ontario.

Speaker, we have done significant strides to broaden screening access for women at risk of breast cancer. We recently lowered the eligibility criteria for self-referral into the Ontario Breast Screening Program to 40 years old. I think we should also assess the lung cancer screening program eligibility because right now it is limited to persons aged 55 to 74, and if the average age of diagnosis is from 40 to 55, that means we really need to look at broadening this eligibility criteria.

Recently, a fellow member shared with me that his sister-in-law passed away from breast cancer at age 40. She was diagnosed with stage 3 cancer and passed away within weeks. That is devastating news. It made me think about all of us here in this House. It is a huge privilege to come in here and serve, but this job also comes with a huge level of stress, and stress can contribute to all chronic diseases, including that it can cause cancer.

So I want to just take this time to encourage all of my fellow members, as we head into the summer break—and we call it a break, but we all know we’ll be working very hard, attending many events, barbecues, meeting with our constituents—please take the time to take care of yourself. Please go get your annual health checkup. Go get your blood work done. Go get your screenings done. Because you can’t take care of your constituents and your family and all the people that rely on you if you don’t take care of yourself. So please, I implore every single one of you to do that over the summer break.

I just want to conclude with a quote from the Canadian Cancer Survivor Network: “Evidence shows that lung cancer caught at an earlier stage has better treatment outcomes. With lung cancer continuing to have the highest mortality rate among all types of cancer, it is more important than ever to ensure that everyone who may be at risk of developing lung cancer has access to the screening programs that could be the difference between life and death.”

Good morning, Madam Speaker. Thank you very much for giving me the opportunity to speak in the House on this topic of paramount importance and which has had profound consequences for so many people here in Ontario and across our country. Of course, I am speaking to the private member’s motion calling for an assessment to expand the Ontario lung cancer screening program.

This is an easy one to support. I’m proud to support it. In fact, the Ontario lung cancer screening program began in 2017 under the Ontario Liberal government, so of course I would want to see this not just continue but succeed.

However, I’m going to begin by echoing the comments from the member from Nickel Belt that this motion could go so much further. For example, why is it calling for an assessment of the expansion of the Ontario lung cancer screening program as opposed to demanding an expansion of that? Why is it even a private member’s motion, which is strictly symbolic, instead of a private member’s bill, which we could all vote on and compel the government to expand the Ontario lung cancer screening program? Why is it that the government member won’t walk across to the Minister of Health and just ask her to expand the Ontario lung cancer screening program?

These are all things that could allow us to devote our time in the chamber to things that require a debate. There’s no question in anyone’s mind in this chamber that all of us agree to the expansion of the Ontario lung cancer screening program. After all, lung cancer is the leading cause of death from cancer in Canada.

And so, I don’t think a lot needs to be said about the merits of expanding the program. Every person in this chamber agrees to it, and I certainly do. The medical community would like to see this happen as well.

Instead, I would like to focus on the things that need to happen in order for us to be able to successfully and effectively fight cancer—lung cancer and all other kinds of malignancies here in this province. I also want to address a little bit some of the challenges that we may face in expanding the Ontario lung cancer screening program, because I am hoping that all of us will vote in favour of this.

The first challenge with the Ontario lung cancer screening program, if it were to be expanded, is that the majority of people in the province don’t know about it. Physicians may know about it. Nurse practitioners may know about it. But the majority of patients and people who are actually at risk don’t know that the program exists. But under this government, we have successive cuts to public health and health promotion activities which could allow people to know that.

Under this government, we have seen the worst health care system performance in our province’s history. We have more people in our province’s history than ever been who don’t have access to primary care: 2.3 million people don’t have it right now; 4.4 million won’t have it by 2026. If you don’t know about the program and can’t self-refer, and you’re one of a growing number of millions of people in our province that don’t have access to a nurse practitioner or a family doctor, how are you supposed to get referred to the Ontario lung cancer screening program?

But let’s say, against all odds, you’re able to surmount all of those challenges. The next thing is you’ve got to be able to find somewhere to get screened. I agree: We do not have enough screening sites. I believe we have five right now. Regrettably, the direction that this government has chosen to go with Bill 60 is to create integrated community diagnostic and surgical service centres. The idea is to be able to increase access to diagnostic and surgical services, but one of the challenges with it that has been brought forward time and time again is that many of the providers for that will be private, for-profit entities that will seek to create these centres in urban centres where the economies of scale and large enough numbers of patients can be generated.

Consequently, people in rural and northern areas will have greater difficulty in being able to access these services. These diagnostic and surgical service centres will draw diagnostic and technological resources away from suburban and rural hospitals and therefore make it more difficult for people to access lung cancer screening in their communities, instead forcing them to make the difficult choice between taking days off from work and travelling—mind you, without adequate funding to the Northern Health Travel Grant, which this government also voted against—and moving to one of these lung cancer referral centres, or not going altogether. So this is something that needs to be addressed if we actually want to expand the Ontario lung cancer screening program and make it a success, and I’m wholeheartedly committed to making it a success along with the member who introduced this motion.

But again, I want to emphasize: If this government was serious about fighting cancer, if this government was serious about detecting malignancies before they become a problem, when they are in a treatable phase, when they haven’t even become cancer yet, then they would have also taken a number of other steps. I understand the Canadian Cancer Society is here, so I know that they’ll agree with me that we need to bring PSA testing under public funding. This government has repeatedly voted against that. How can this government say they are serious about fighting cancer, about screening for cancer, when they repeatedly, time and time again, in the face of the Canadian Cancer Society, which is sitting right here—how can they vote down funding testing for PSA?

This is a government that, again, has chosen not to fund take-home cancer drugs.

This is a government that has not committed to delivering a family doctor for every single person in this province.

And the final thing: I salute the member who introduced this motion for enumerating many of the risk factors for lung cancer and for cancer generally. I agree we don’t talk enough and people don’t know enough about things like asbestos and radon. We could do more work to help people quit smoking and raise awareness around issues such as vaping and children.

However, one risk factor that she did not mention, a leading risk factor for cancer in our province and in our country, is alcohol. So you can imagine how perplexed I am that this government—with, admittedly, a limited budget in health care and, just provincially, a government that has a record debt and deficit unprecedented in our province’s history—rather than investing a billion dollars in health care, in cancer screening, in fighting malignancies, instead chose to commit to invest that $1 billion in a risk factor for cancer by trying to bring beer to convenience stores a mere one year early. This government is twisted in knots and cannot get its priorities straight.

So I’m going to keep my remarks brief. I think I have made it clear that I entirely and wholeheartedly support expansion of the lung cancer screening program. However, I think and hope that I’ve also illustrated the folly in the way this motion has been presented. I hope that people will take away from this that this should have been a bill, or even better, it should have been a conversation with the Minister of Health. It should have been not a request for an assessment to expand the lung cancer screening program; it should have been a demand to expand the lung cancer screening program. It should have called for including funding for PSA testing. It should have called for take-home cancer screening.

I don’t know which minister brought it in, but it should have called for the government to instead invest their billion dollars not on bringing beer to convenience stores one year early, but to invest it in health care, in getting a family doctor for everyone, in supporting this program. It doesn’t.

It’s a flawed motion that we’ll support nonetheless because I and the people in the House will stands with patients in Ontario. We do want to fight cancer, and we’re committed to showing this government the right way to do it.

It’s an honour to rise today to speak to motion 77, to look at the possibility of expanding the lung cancer screening program. It’s a motion I’ll be voting for, and I appreciate the member from Mississauga Centre for bringing it forward.

Speaker, I believe the lung association has already brought forward compelling arguments of why we need to expand the number of screening sites in Ontario—we only have five, far less than other provinces with smaller populations—and why we need to expand the scope beyond smokers. We know smoking is a cause of lung cancer, but increasingly people are being diagnosed with lung cancer who have never smoked. That is where we’re seeing the rising number of lung cancer cases. So expanding the scope of the screening is critically important as well.

My hope is that this motion passes today, but I’m hoping the member takes this motion directly to the Minister of Health and says, “We have to put this motion into action.” While the member is having that conversation with the minister, I’m hoping the member will say, “Why not expand screening for all cancers?”

Just as I was walking in here, I got a phone call from my doctor with the results of my latest PSA test. It would be great if all men could get a PSA test covered under OHIP. I’m lucky I have insurance coverage on it, but a lot of people don’t. But it should be all cancers, because we know that the earlier we detect—and I know the member knows this, as a nurse—the more likely we are to cure. As the member opposite just stated, 11,000 cases of lung cancer, 7,000 deaths—and most of the time, they’re detected at stage four. The earlier we can detect, the more likely we know people can survive.

So what is it going to take for early detection? Well, I’m one of those lucky people. I have a family doctor. I’m not one of those 2.3 million Ontarians who don’t have access to a family doctor. My access to screening and the information that I need around screening for all types of cancer comes from my family doctor.

I just had my annual physical a couple of weeks ago, and my doctor said, “You might be at risk for colon, you might be at risk for prostate, you might”—he just listed it off and said, “Here is where you go. I am going to give you the requisition form for the blood work and other screening that you need.” Not everyone has that. So, if we’re going to look at early screening of lung cancer and all forms of cancer, then we need to make sure everyone has access to a family doctor, who is a gateway to that screening.

Then of course, when it comes to lung cancer, we have so few sites around the province that even if your doctor says, “Hey, you’re eligible for screening. We’ll sign the requisition forms for you to do that,” it becomes very challenging for people to access screening because they don’t live near a place where they can access screening. So, I wanted to put that on the record.

I want to close—and I’m not going to use all of my time—on a few important notes that came out of my last meeting with the lung association, because one thing that hasn’t been talked about enough, I believe, is how do we prevent lung cancer in the first place and what are some of the growing threats to lung cancer that could possibly help explain why we’re seeing such growth in lung cancer from people who don’t smoke. Some of those have been mentioned today, and I appreciate the member opposite talking about it.

One is radon testing, ensuring that we have radon testing for homes, easily accessible and available, for people and in workplaces.

Second is looking at air pollution. When I met with the lung association, they had three key recommendations around reducing air pollution. One was better testing, especially of traffic-related air pollution, which historically affects more vulnerable and low-income neighbourhoods. We know from some testing that the University of Toronto did in the city of Toronto that neighbourhoods that are located closer to Highway 427, the Gardiner Expressway, the Don Valley Parkway and larger boulevards like Steeles Avenue, for example, have higher levels of air pollution, which contribute to lung cancer.

The other one is people who live in close proximity to gas plants. So the Portlands gas plant, for example, in the Beaches in Toronto, is the largest single source of air pollution in the city of Toronto. And you’re seeing that in other places. In Halton, for example, people who live around the Halton gas plant—for those of you like myself, I travel between Guelph and Toronto all the time, and I drive right by it on the 401—one, minimizing the use of those gas plants in the first place to minimize the toxic air pollution, but two, making sure we have air screening in place to make sure the pollution levels are not at elevated levels, affecting human health and potentially affecting people with lung cancer.

The second area they talked about with me was the importance of indoor air quality and ensuring that we have proper filtration and filters like HEPA filters in buildings, in homes and especially in schools, where children are incredibly vulnerable, as a way to help mitigate lung cancers.

Then the next one was, interestingly enough, school buses. Most of our school buses are diesel engines. We know the particulate matter from diesel engines negatively affects people’s lungs. The sooner we can electrify school buses to reduce that particulate matter, the more protections we provide for children. Because we know that the airborne pollution from diesel engines is particularly dangerous for young people and their lungs.

The final one in this category is forest fires. Last year, a million acres burned in Ontario. During four days in the first week of June, that cost our health care system $1.28 billion, primarily due to admissions to emergency departments for people with respiratory problems, oftentimes asthma related. But that toxic air affects people’s lungs. We don’t know yet what the implications are for lung cancer, but the lung association is deeply concerned about the long-term effects of persistent exposure to forest fires. Obviously, our wildland firefighters are the most at risk; they’re the ones on the front lines, and we need to make sure they have the proper PPE and masks and things to protect them, but just average folk walking around our communities are affected, as well.

Making sure that we do everything we can to reduce fire risk and we have firefighting in place—and I think we’re going to have to start looking for folks who have had persistent exposure to toxic air from firefighting being part of the screening process, because they are going to be at risk.

And then finally, on the prevention side, I want to just talk a little bit—I know the member from Nickel Belt talked about vaping. I think we’re going to need stronger rules to ramp up smoking prevention. Even though we’ve done a good job, we still aren’t there yet. But where we’re really having a challenge now is with vaping and with young people. We know the lung association is deeply concerned about the cancer implications of rising rates of vaping, especially among young people—so to make sure we have the rules and regulations in place to prevent that, to reduce vaping and to prevent the long-term implications of that.

I want to close by saying that the lung association said to me, one in five people suffer from lung disease; five in five people breathe. The best way to prevent lung disease, lung cancer is to make sure the air we breathe is clean and healthy. That is something I’m hoping that, if all of us are going to vote for this motion, we can draw inspiration and work across party lines to do everything we can to ensure the air we breathe is clean and healthy.

I’m pleased to rise in support of this motion. This issue is near and dear to my heart. I lost my grandmother, both my aunts on my father’s side and my aunt on my mother’s side to cancer. To this day, I believe that if they had access to early screening, their lives could have been prolonged or perhaps saved.

As part of looking into this motion, I was shocked to learn that lung cancer kills more people in Ontario than brain cancer, bladder cancer, leukemia, prostate cancer, breast cancer and stomach cancer combined. In fact, the probability of dying from cancer is highest in the case of lung cancer for both males and females.

The reason for this high probability of dying from lung cancer has to do with the fact that lung cancer survival rates vary significantly depending on the stage of diagnosis. If someone is diagnosed at stage 1, their chance of survival is 60%, and it drops to below 5% if they’re diagnosed at stage 4, when many people unfortunately are diagnosed. This underscores the importance of diagnosing lung cancer as early as possible.

One statistic that jumped out was that 70% of lung cancers in Canada are diagnosed at an advanced stage, unfortunately. That makes a difference between life and death. That means that someone’s parent or their brother or their sister or their friend might have survived and gone on to live many years of productive life, many productive years.

Lung Cancer Canada agrees that comprehensive lung cancer screening programs are essential to improving early detection rates and saving lives. While lung cancer continues to have the highest mortality rate among all types of cancer, it is more important than ever to ensure that everyone who may be at risk of developing lung cancer has access to early screening programs.

Speaker, I’m proud to be part of the government that takes health care seriously and is investing $85 billion in health care, nearly $25 billion more than the previous government. This is the government that ended hallway health care that plagued the province under the previous government. In the past five years, we’ve added over 3,500 hospital beds. We’re building 50 new hospital projects through our $50-billion investment to add 3,000 more. Since 2018, 80,000 new nurses and 10,400 new doctors have registered to work in Ontario. We were the first province in Canada to introduce as-of-right rules to allow health care workers to move to Ontario from other provinces to start working immediately.

Our government provides an organized screening program, the Ontario Lung Screening Program, that helps screen people at high risk of getting lung cancer. This program is open to people between the ages of 55 and 74 years old who have smoked cigarettes every day for 20 years and not necessarily 20 years in a row. As the House is aware, currently this program operates at four main sites: Oshawa, Toronto, Sudbury and Ottawa.

Looking into broadening the eligibility criteria for access to the lung screening program might catch cancer at earlier stages for a lot of people who today don’t have access to the screening programs. Adding another site in or around the Peel region may also provide access to people who currently don’t have access to one of the four sites.

This private member’s motion will hep us determine whether an expansion to the screening program is warranted and whether we should broaden the eligibility criteria for access to the lung screening program.

While my riding is not in the Peel region, it is adjacent to Peel, and residents of my riding and other residents of Halton travel routinely to Peel for their health care needs.

In fact, my father is in Trillium hospital right now in the Peel region, as I speak, for his angiography. My uncle was recently admitted to Credit Valley Hospital, also in the Peel region, for his cardiovascular disease.

Should Peel be selected as one of the sites for the expansion of the lung screening program, it would not only help the 1.5 million residents of Peel region but also over 600,000 people in the Halton region.

As the House is aware, both Peel and Halton are among the fastest-growing regions in Ontario. Under the provincial growth plan, the Halton region is projected to grow to 1.1 million people by 2051, and the Peel region is projected to grow to 2.28 million people.

While it is common for people in my riding and the rest of Halton region to travel to Peel for complex health care needs, the same cannot be said about travelling to Ottawa, Sudbury, Oshawa or Toronto, where lung cancer screening centres are currently. I fear that many might forgo screening that might have caught the cancer for them at an earlier stage and could have saved their lives.

Speaker, I thank the member from Mississauga Centre for her motion as well as her advocacy on this very important issue. I support this motion and urge my colleagues to do the same because better access to lung cancer screening can help find lung cancer early, which is when the treatment has the best chance of working. I’m looking forward to seeing my colleagues support this motion.