Abstract
The objectives of the present study were to estimate the overall and specific medical care costs associated with cervical cancer in the first 5 years after diagnosis in Ontario. Incident cases of invasive cervical cancer during 2007-2010 were identified from the Ontario Cancer Registry and linked to administrative databases held at the Institute for Clinical Evaluative Sciences. Mean costs in 2010 Canadian dollars were estimated using the arithmetic mean and estimators that adjust for censored data. Mean age of the patients in the study cohort (779 cases) was 49.3 years. The mean overall medical care cost was $39,187 [standard error (se): $1,327] in the 1st year after diagnosis. Costs in year 1 ranged from $34,648 (se: $1,275) for those who survived at least 1 year to $69,142 (se: $4,818) for those who died from cervical cancer within 1 year. At 5 years after diagnosis, the mean overall unadjusted cost was $63,131 (se: $3,131), and the cost adjusted for censoring was $68,745 (se: $2,963). Inpatient hospitalizations and cancer-related care were the two largest components of cancer treatment costs. We found that the estimated mean costs that did not account for censoring were consistently undervalued, highlighting the importance of estimates based on censoring-adjusted costs in cervical cancer. Our results are reliable for estimating the economic burden of cervical cancer and the cost-effectiveness of cervical cancer prevention strategies.
Highlights
Cancer is the leading cause of death in Canada, accounting for nearly 30% of all mortality[1]
Costs in year 1 ranged from $34,648 for those who survived at least 1 year to $69,142 for those who died from cervical cancer within 1 year
We found that the estimated mean costs that did not account for censoring were consistently undervalued, highlighting the importance of estimates based on censoring-adjusted costs in cervical cancer
Summary
Cancer is the leading cause of death in Canada, accounting for nearly 30% of all mortality[1]. Cancer is one of the most costly diseases[2], and its economic burden is substantial in Canada. The direct cost of cancer care in Canada in 2008 was estimated at $4 billion[3]. Cervical cancer is the 2nd leading cause of cancer death among Ontario women 20–44 years of age[4], and the 4th most common cause of cancer death among women worldwide[5]. Of every 145 Ontario women, 1 will be diagnosed with cervical cancer during her lifetime, and each year in Ontario, approximately 610 women are diagnosed with cervical cancer, and approximately 150 die from the disease[1]. Of Ontario women diagnosed with cervical cancer in
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