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CANADIAN CANCER RISK MANAGEMENT MODEL: EVALUATION OF CANCER CONTROL

Published online by Cambridge University Press:  20 March 2013

William K. Evans ,
Michael C. Wolfson ,
William M. Flanagan ,
Janey Shin ,
John Goffin ,
Anthony B. Miller ,
Keiko Asakawa ,
Craig Earle ,
Nicole Mittmann  and
Lee Fairclough
...Show all authors
William K. Evans
Affiliation:
Juravinski Cancer Centre at Hamilton Health Sciences and McMaster University
Michael C. Wolfson
Affiliation:
Population Health Modeling/Populomics, University of Ottawa
William M. Flanagan
Affiliation:
Health Analysis and Modeling Divisions, Statistics Canada
Janey Shin
Affiliation:
Canadian Partnership Against Cancer
John Goffin
Affiliation:
Juravinski Cancer Centre at Hamilton Health Sciences and McMaster University
Anthony B. Miller
Affiliation:
Dalla Lana School of Public Health, University of Toronto
Keiko Asakawa
Affiliation:
Health Analysis and Modeling Division, Statistics Canada
Craig Earle
Affiliation:
Institute for Clinical Evaluative Sciences andUniversity of Toronto
Nicole Mittmann
Affiliation:
Centre for Health Outcomes and Pharmacoeconomic Evaluation, Sunnybrook Health Sciences Centre andUniversity of Toronto
Lee Fairclough
Affiliation:
Canadian Partnership Against Cancer
Jillian Oderkirk
Affiliation:
Health Analysis and Modeling Divisions, Statistics Canada
Philippe Finès
Affiliation:
Health Analysis and Modeling Divisions, Statistics Canada
Stephen Gribble
Affiliation:
Health Analysis and Modeling Divisions, Statistics Canada
Jeffrey Hoch
Affiliation:
Pharmacoeconomics Research Unit, Cancer Care Ontario; The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Canada; Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Institute of Health Policy, Management and Evaluation, University of Toronto
Chantal Hicks
Affiliation:
Health Analysis and Modeling Divisions, Statistics Canada
D. Walter R. Omariba
Affiliation:
Health Analysis and Modeling Divisions, Statistics Canada
Edward Ng
Affiliation:
Health Analysis and Modeling Divisions, Statistics Canada
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Abstract

Objectives: The aim of this study was to develop a decision support tool to assess the potential benefits and costs of new healthcare interventions.

Methods: The Canadian Partnership Against Cancer (CPAC) commissioned the development of a Cancer Risk Management Model (CRMM)—a computer microsimulation model that simulates individual lives one at a time, from birth to death, taking account of Canadian demographic and labor force characteristics, risk factor exposures, and health histories. Information from all the simulated lives is combined to produce aggregate measures of health outcomes for the population or for particular subpopulations.

Results: The CRMM can project the population health and economic impacts of cancer control programs in Canada and the impacts of major risk factors, cancer prevention, and screening programs and new cancer treatments on population health and costs to the healthcare system. It estimates both the direct costs of medical care, as well as lost earnings and impacts on tax revenues. The lung and colorectal modules are available through the CPAC Web site (www.cancerview.ca/cancerrriskmanagement) to registered users where structured scenarios can be explored for their projected impacts. Advanced users will be able to specify new scenarios or change existing modules by varying input parameters or by accessing open source code. Model development is now being extended to cervical and breast cancers.

Keywords

CancerSimulation modelPolicy tool
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 29 , Issue 2 , April 2013 , pp. 131 - 139
Copyright
Copyright © Cambridge University Press 2013

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References

REFERENCES

1.Canadian Partnership against Cancer. www.partnershipagainstcancer.ca (accessed December 15, 2012).Google Scholar
2.Wolfson, WC.POHEM—a framework for understanding and modeling the health of human populations. World Health Stat Q. 1994;47:157–176.Google ScholarPubMed
3.American Cancer Society Cancer Statistics 2009 Presentation. http://www.cancer.org/docroot/PRO/content/PRO_1_1_Cancer_Statistics_2009_Presentation.asp (accessed August 20, 2011).Google Scholar
4.Canadian Cancer Society's Steering Committee. Canadian cancer statistics 2009. Toronto: Canadian Cancer Society, 2009.Google Scholar
5.Moller, H, Fairley, L, Coupland, V, et al.The future burden of cancer in England: incidence and numbers of new patients in 2020. Br J Cancer. 2007;96:1484–1488.CrossRefGoogle ScholarPubMed
6.Smoke-free Ontario Cessation and Prevention Programs. http://www.mhp.gov.on.ca/en/smoke-free/default.asp (accessed September 17, 2011).Google Scholar
7.National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365:395–409.CrossRefGoogle Scholar
8.Winton, T, Livingston, R, Johnson, D, et al.Vinorelbine plus cisplatin versus observation in resected non-small cell lung cancer. N Engl J Med. 2005;352:2589–2597.CrossRefGoogle Scholar
9.Goffin, J, Coakley, N, Ellis, P, et al. Cancer Care Ontario Evidence-based series #7–10. First-line systemic chemotherapy in the treatment of advanced non-small cell lung cancer: Evidentiary base 2009. www.cancercare.on.ca (accessed December 20, 2011).Google Scholar
10.ColonCancerCheck. http://www.health.gov.on.ca/en/public/programs/coloncancercheck/ (accessed December 20, 2011).Google Scholar
11.Jonker, D, Spithoff, K, Maroun, J.Adjuvant systemic chemotherapy for stage II and III colon cancer following complete resection: Guidelines recommendations. Evidence-based series #2–29 www.cancercare.on.ca (accessed Month day, year).Google Scholar
12.Segal, NH, Saltz, LB.Evolving treatment of advanced colon cancer. Annu Rev Med. 2009;60:207–219.CrossRefGoogle ScholarPubMed
13.Evans, WK, Will, BP, Berthelot, J-M, Wolfson, MC.Estimating the cost of lung cancer diagnosis and treatment in Canada: the POHEM model. Can J Oncol. 1995;5:408–419.Google ScholarPubMed
14.Maroun, J, Ng, E, Berthelot, J-M, et al.Lifetime costs of colon and rectal cancer management in Canada. Chronic Dis Can. 2003;24:91–101.Google ScholarPubMed
15.Will, BP, Berthelot, J-M, LePetit, C, et al.Estimates of the lifetime costs of breast cancer treatment in Canada. Eur J Cancer. 2000;36:724–735.CrossRefGoogle ScholarPubMed
16.Will, BP, Le Petit, C, Berthelot, J-M, et al.Diagnostic and therapeutic approaches for non-metastatic breast cancer in Canada, and their associated costs. Br J Cancer. 1999;79:1428–1436.CrossRefGoogle Scholar
17.Berthelot, J-M, Will, BP, Evans, WK, et al.Decision framework for chemotherapeutic interventions for metastatic non-small cell lung cancer. J Natl Cancer Inst. 2000;92:1321–1329.CrossRefGoogle ScholarPubMed
18.Evans, WK, Will, BP, Berthelot, J-M, et al.Breast cancer: Better care for less cost: Is it possible? Int J Technol Assess Health Care. 2000;16:1168–1178.CrossRefGoogle ScholarPubMed
19.Flanagan, W, Le Petit, C, Berthelot, J-M, et al.Potential impact of population-based colorectal cancer screening in Canada. Chronic Dis Can. 2003;24:81–88.Google ScholarPubMed
20.Will, BP, Berthelot, J-M, Nobrega, KM, Flanagan, W, Evans, WK.Canada's Population Health Model (POHEM): A tool for performing economic evaluations of cancer control interventions. Eur J Cancer. 2001;37:1797–1804.CrossRefGoogle ScholarPubMed
21.Will, BP, Nobrega, KM, Berthelot, J-M, et al.First do no harm: Extending the debate on the provision of preventive tamoxifen. Br J Cancer. 2001;85:1280–1288.CrossRefGoogle ScholarPubMed
22.Whittemore, AS, McMillan, A.Lung cancer mortality among US uranium miners: A reappraisal. J Natl Cancer Inst. 1983;71:489–499.Google Scholar
23.Winawer, SJ, Zauber, AG, Ho, MN, et al.Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med. 1993;329:1977–1981.CrossRefGoogle ScholarPubMed
24.Kronborg, O, Fenger, C, Olsen, J, Jorgensen, OD, Sondergaard, O.Randomized study of screening for colorectal cancer with fecal occult blood test. Lancet. 1996;348:1467–1471.CrossRefGoogle Scholar
25.Church, TR, Mandel, JS, Bond, JH, Ederer, F.Colorectal cancer incidence reduction due to polyp removal: Results from the Minnesota trial. Gastroenterology. 2003;124 (Suppl 1):A55.CrossRefGoogle Scholar
26.Lieberman, DA.Screening for colorectal cancer. N Engl J Med. 2009;361:1179–1187.CrossRefGoogle ScholarPubMed
27.Horsman, J, Furlong, W, Feeney, D, Torrance, G.The Health Utilities Index (HUI): Concepts, measurement properties and applications. Health Qual Life Outcomes. 2003;1:54.CrossRefGoogle ScholarPubMed
28.Statistics Canada. National population health survey. http://www.statcan.gc.ca/cgi-bin/imdb/p2SV.pl?Function=getSurvey&SDDS=3225&lang=en&db=imdb&dbg=f&adm=8&dis=2 (accessed December 20, 2011).Google Scholar
29.Statistics Canada. Canadian community health survey. http://www23.statcan.gc.ca:81/imdb/p2SV.pl?Function=getSurvey&SDDS=3226&lang=en&db=imdb&adm=8&dis=2 (accessed November 26, 2011).Google Scholar
30.Evans WK, Connor Gorber SK, Spence ST, Will BP; for the Population Health Impact of Disease in Canada (PHI). Health state descriptions for Canadians. Cancers. Statistics Canada, catalogue no. 82–619-MIE2005001. Ottawa: Statistics Canada, 2005Google Scholar
31.McIntosh, CN, Gorber, S, Bernier, J, Berthelot, J-M. Eliciting Canadian population preferences for health states using the Classification and Measurement System of Functional Health (CLAMES). Chron Dis Can. 2007;28:29–41.Google ScholarPubMed
32.Flanagan, WM, McIntosh, CN, Berthelot, J-M, LePetit, C.Deriving utility scores for co-morbid conditions: a test of the multiplicative model for combining individual condition scores. Popul Health Metr. 2006;4:13 doi:10.1186/1478–7954-4-13.CrossRefGoogle ScholarPubMed
33.Statistics Canada. General social survey. http://www.statcan.gc.ca/cgi-bin/imdb/p2SV.pl?Function=getSurvey&SDDS=8011&lang=en&db=imdb&adm+8&dis=2 (accessed November 26, 2011).Google Scholar
34.Statistics Canada. Canada health survey. http://www23.statcan.gc.ca:81/imdb/p2SV.pl?Function=getSurvey&SDDS=3217&lang=en&db=imdb&adm=8&dis=2 (accessed November 26, 2011).Google Scholar
35.Navaratnam, S, Kliever, EV, Butler, J, et al.Population-based patterns and cost management of metastatic non-small cell lung cancer after completion of chemotherapy until death. Lung Cancer. 2010;70:110–115. doi:10.1016/j.lungcan.2010.01.012.CrossRefGoogle ScholarPubMed
36.Statistics Canada. 2007. 2006 census dictionary. Statistics Canada catalogue no. 92 – 566 – XWE. Ottawa. http://www12.statcan.ca/english/census06/reference/dictionary/index.cfm (accessed November 26, 2011)Google Scholar
37.Bordt, M, Cameron, G, Gribble, S, et al.The social policy simulation database and model: An integrated tool for tax/transfer policy analysis. Can Tax J. 1990;38.Google Scholar
38.Cancerview.ca. Cancer risk management model 1.0. www.cancerview.ca/canceriskmanagement (accessed January 7, 2012).Google Scholar
39.Butts, CA, Ding, K, Seymour, L, et al.Randomized phase III trial of vinorelbine plus cisplatin compared with observation in completely resected stage IB and II non-small-cell lung cancer: Updated survival analysis of JBR-10. J Clin Oncol. 2009;28:29–34.CrossRefGoogle ScholarPubMed
40.Evans, WK, Feld, R, Murray, N, et al.Superiority of alternating non-cross-resistant chemotherapy in extensive small cell lung cancer. Ann Int Med. 1987;107:451–458.CrossRefGoogle ScholarPubMed
41.Feld, R, Evans, WK, Coy, P, et al.Canadian multicentre randomized trial comparing sequential and alternating administration of two non-cross-resistant chemotherapy combinations in patients with limited small-cell carcinoma of the lung. J Clin Oncol. 1987;5:1401–1409.CrossRefGoogle Scholar
42.Holmes EC, Gail M, for the Lung Cancer Study Group. Surgical adjuvant therapy for stage II and stage III adenocarcinoma and large-cell undifferentiated carcinoma. J Clin Oncol. 1986;4:710–715.CrossRefGoogle Scholar
43.Johnson, DH, Einhorn, LH, Bartolucci, A, et al.Thoracic radiotherapy does not prolong survival in patients with locally advanced, unresectable non-small cell lung cancer. Ann Int Med. 1990;113:33–38.CrossRefGoogle Scholar
44.Mountain, CM, Gail, MH.The Lung Cancer Study Group: Surgical adjuvant intrapleural BCG treatment for stage I non-small cell lung cancer. J Thorac Cardiovasc Surg. 1981;82:649–657.CrossRefGoogle Scholar
45.Perez, CA, Stanley, K, Rubin, P, et al.A prospective randomized study of various irradiation doses and fractionation schedules in the treatment of inoperable non-oat-cell carcinoma of the lung: Preliminary Report by the Radiation Therapy Oncology Group. Cancer. 1980;45:2744–2753.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
46.Rapp, E, Pater, JL, Willan, A, et al.Chemotherapy can prolong survival in patients with advanced non-small cell lung cancer. Report of a Canadian multicentre randomized trial. J Clin Oncol. 1988;6:633–641.CrossRefGoogle Scholar
47.McGregor, R, Vasudev, P, Letourneau, E, et al.Background concentration of radon and radon daughters in Canadian homes. Health Phys. 1980;39:285–289.CrossRefGoogle ScholarPubMed
48.Eheman, C, Henley, SJ, Ballard-Barbash, R, et al.Annual report to the nation on the status of cancer 1975–2008, featuring cancers associated with excess weight and lack of sufficient physical activity. Cancer. 2012;118:2338–2366. doi:10.1002/cncr.27514CrossRefGoogle Scholar
49.Fojo, T, Grady, C.How much is life worth: cetuximab, non-small cell lung cancer and the $440 billion question. J Natl Cancer Inst. 2009;101:1044–1048.CrossRefGoogle ScholarPubMed
50.Breakaway: The global burden of cancer – challenges and opportunities. A report from the Economist Intelligence Unit. http://livestrongblog.org/GlobalEconomicImpact.pdf (accessed Month day, year).Google Scholar
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