Trends in use and cost of initial cancer treatment in Ontario: a population-based descriptive study

The incidence of cancer in Canada has increased recently owing to population growth and aging. This increased incidence, in addition to the increased use of expensive new drugs and technologies to treat cancer, has led to a rise in cancer-related expenditures, which consume a growing share of limited health care budgets. Previous studies have shown that many cancer-related costs are incurred in the year after diagnosis. However, which resources and health services contribute most to the overall cost and whether rising prices or increased use can explain increased expenditures is not yet fully understood. We examined temporal trends in use of health care resources and costs for melanoma, breast cancer (in women only), testicular cancer and thyroid cancer among patients aged 19–44 years, and for breast (in women only), prostate, lung and colorectal cancers among patients aged 45 years and older to understand how patterns of care and associated costs for these cancers have changed. Our age cut-offs are based on previous work because there is no standard international definition of “young adult”; our rationale is that young adulthood stretches from the end of adolescence to the start of menopause, in which the latter is known to induce marked changes in the cancer profile of women. We chose these types of cancer because they account for about 60% of all cancers in each of the age groups included in our study. We sought to identify current cancer care needs to help predict trends in cancer care use and expenditures. Trends in use and cost of initial cancer treatment in Ontario: a population-based descriptive study