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Current Oncology
Volume 23
Issue s1
10.3747/co.23.2946
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Population-Based Trends in Systemic Therapy Use and Cost for Cancer Patients in the Last Year of Life

by
R.E. Pataky
1,2,*,
W.Y. Cheung
2,
C. de Oliveira
1,3,
K.E. Bremner
4,
K.K.W. Chan
1,5,
J.S. Hoch
1,
M.D. Krahn
4,6 and
S.J. Peacock
1,2,7
1
Canadian Centre for Applied Research in Cancer Control, Toronto, ON, and Vancouver, BC, Canada
2
BC Cancer Agency, Vancouver, BC, Canada
3
Centre for Addiction and Mental Health, Toronto, ON, Canada
4
Toronto General Research Institute and The Toronto Health Economics and Technology Assessment Collaborative, University Health Network, Toronto, ON, Canada
5
Department of Medicine, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
6
Faculty of Pharmacy, University of Toronto, University Health Network, Toronto, ON, Canada
7
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2016, 23(s1), 32-41; https://doi.org/10.3747/co.23.2946
Submission received: 12 November 2015 / Revised: 10 December 2015 / Accepted: 13 January 2016 / Published: 1 February 2016

Abstract

Background: The use of systemic therapy near the end of life can expose cancer patients to severe toxicity for minimal survival gain and comes with a high cost. Early palliative care is recommended, but there is evidence that aggressive care remains common. To better understand those patterns, the present study set out to describe trends in systemic therapy use and cost for cancer patients in the last year of life. Methods: Using the BC Cancer Registry, a retrospective population-based cohort of cancer decedents (2002–2007) was identified and linked to systemic therapy records. The outcomes of interest were any systemic therapy use and total systemic therapy costs during the last year of life. Multiple logistic regression (systemic therapy use) and generalized linear regression (costs) were conducted, adjusting for age, sex, and survival. Subgroup analyses were performed for patients with primary colorectal, lung, prostate, or breast cancer. Results: From 2002 to 2007, use of systemic therapy in the last 12–4 months of life increased by 21% (95% CI: 10% to 33%); no significant change in use in the last 3 months of life was observed. Costs for both periods increased over time, by 48% (95% CI: 36% to 63%) and by 33% (95% CI: 19% to 49%) respectively. The trends varied across cancer sites, with the greatest increases being observed for lung and colorectal cancer patients. Conclusions: The use and costs of systemic therapy have generally been increasing, putting pressure on health care providers and payers, but the quality-of-life implications for patients must be better understood.
Keywords: Systemic therapy; chemotherapy; costs; end-of-life care; palliative care Systemic therapy; chemotherapy; costs; end-of-life care; palliative care

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MDPI and ACS Style

Pataky, R.E.; Cheung, W.Y.; de Oliveira, C.; Bremner, K.E.; Chan, K.K.W.; Hoch, J.S.; Krahn, M.D.; Peacock, S.J. Population-Based Trends in Systemic Therapy Use and Cost for Cancer Patients in the Last Year of Life. Curr. Oncol. 2016, 23, 32-41. https://doi.org/10.3747/co.23.2946

AMA Style

Pataky RE, Cheung WY, de Oliveira C, Bremner KE, Chan KKW, Hoch JS, Krahn MD, Peacock SJ. Population-Based Trends in Systemic Therapy Use and Cost for Cancer Patients in the Last Year of Life. Current Oncology. 2016; 23(s1):32-41. https://doi.org/10.3747/co.23.2946

Chicago/Turabian Style

Pataky, R.E., W.Y. Cheung, C. de Oliveira, K.E. Bremner, K.K.W. Chan, J.S. Hoch, M.D. Krahn, and S.J. Peacock. 2016. "Population-Based Trends in Systemic Therapy Use and Cost for Cancer Patients in the Last Year of Life" Current Oncology 23, no. s1: 32-41. https://doi.org/10.3747/co.23.2946

APA Style

Pataky, R. E., Cheung, W. Y., de Oliveira, C., Bremner, K. E., Chan, K. K. W., Hoch, J. S., Krahn, M. D., & Peacock, S. J. (2016). Population-Based Trends in Systemic Therapy Use and Cost for Cancer Patients in the Last Year of Life. Current Oncology, 23(s1), 32-41. https://doi.org/10.3747/co.23.2946

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