Abstract
INTRODUCTION: The United States of America reignited their Cancer Moonshot Initiative in 2022 with an ambitious goal to reduce cancer mortality by 50% over the next 25 years. In this study, we estimated how and whether a similar cancer control initiative could be achieved in Canada. METHODS: We used the OncoSim microsimulation suite to address three questions: (1) what is the expected mortality from cancer in Canada by 2050 given the current trends?; (2) what would be the maximal impact on reducing cancer mortality with prevention and increased screening activities? and, (3) if a 50% reduction in projected cancer mortality could not be achieved through the primary and secondary intervention efforts, what additional advancements and discoveries would be needed to fill the "lunar gap"? We modeled the joint impact of risk-factor reduction and screening, as well as the independent effects of prevention and screening alone, on projected cancer mortality. RESULTS: Our models suggest that there will be an expected 133,395 cancer deaths in 2050 in Canada. Approximately 33% of these cancer deaths could be prevented by risk-factor reduction and increased screening programs by the year 2050. This would leave a "lunar gap" of about 16%-17% that would need to be bridged with novel discoveries in cancer risk prevention, early detection, and treatment. CONCLUSION: While current knowledge and implementation of prevention and screening would have a considerable impact on a Canadian cancer moonshot, additional efforts are needed to implement cancer control initiatives and fuel additional discoveries to fill the gap.