To estimate the direct medical care costs of childhood cancer from a health system perspective, and to determine which elements influence these costs.
Research QuestionsUsing cancer registry and administrative data linked within each of BC and ON, we propose to:
- Estimate the costs of care overall and for four groups of childhood cancer (3 most common types: leukemia, central nervous system tumours, and lymphoma, and a fourth consisting of all other cancers) for three phases of care: initial, continuing/survivor, and terminal.
- Determine the main sociodemographic, clinical, and health system predictors of costs, overall and for each cancer group, and each costing phase.
- Measure time trends in health service utilization and costs during the first year after diagnosis, overall and for each childhood cancer group and relate temporal changes to changes in treatment and the frequency of late complications.
- Estimate 1-year, 5-year, and 10-year costs overall and for the most common cancers using the phase-based costing approach and appropriate statistical methods.
Study cohorts will be identified from the Childhood/Adolescent/Young Adult Cancer Survivors (CAYACS) Research Program at the British Columbia Cancer Agency and the Pediatric Oncology Group of Ontario Network Information System (POGONIS) at the Pediatric Oncology Group of Ontario (POGO). We will select patients diagnosed from January 1, 1995, to December 31, 2010, at ages 0 to 19 years with a cancer or tumour included in the International Classification of Childhood Cancers (ICCC).
We will exclude patients who have an incorrect or missing histology code, a date of diagnosis that is the same as the date of death, not residents of
Design and Methods
Each province will work with its own data. In
July 2012 - December 2015
Progress: Costs for 90 days before diagnosis and one year after diagnosis, phase-specific costs,and time trends in first-year costs have been estimated for the childhood cancer cohort in Ontario. Estimation of costs for longer time periods is underway. An oral presentation on first-year costs was givenat the conference of The Canadian Association for Population Therapeutics , November 1 – 3, 2015 in Toronto, Ontario. A manuscript is being prepared for journal submission. Other manuscript preparation is underway.
Karen E. Bremner, BSc
Canadian Institutes of Health Research