Evidence map›Paper›PMID 26985144›Full record

ArticleCurrent oncology (Toronto, Ont.)2016

Population-based trends in systemic therapy use and cost for cancer patients in the last year of life.

R E Pataky, W Y Cheung, C de Oliveira, K E Bremner, K K W Chan, J S Hoch, M D Krahn, S J Peacock

Abstract read
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In one paragraph

Article in Current oncology (Toronto, Ont.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Potentially inappropriate end-of-life care and its association with relatives' well-being: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Pooled it
  3. Article
  4. Observational
  5. Article
  6. Observational
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

R E PatakyCanadian Centre for Applied Research in Cancer Control, Toronto, ON, and Vancouver, BC;; BC Cancer Agency, Vancouver, BC;
W Y CheungBC Cancer Agency, Vancouver, BC;
C de OliveiraCanadian Centre for Applied Research in Cancer Control, Toronto, ON, and Vancouver, BC;; Centre for Addiction and Mental Health, Toronto, ON;
K E BremnerToronto General Research Institute and The Toronto Health Economics and Technology Assessment Collaborative, University Health Network, Toronto, ON;
K K W ChanCanadian Centre for Applied Research in Cancer Control, Toronto, ON, and Vancouver, BC;; Department of Medicine, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, ON;
J S HochCanadian Centre for Applied Research in Cancer Control, Toronto, ON, and Vancouver, BC;
M D KrahnToronto General Research Institute and The Toronto Health Economics and Technology Assessment Collaborative, University Health Network, Toronto, ON;; Faculty of Pharmacy, University of Toronto, University Health Network, Toronto, ON;
S J PeacockCanadian Centre for Applied Research in Cancer Control, Toronto, ON, and Vancouver, BC;; BC Cancer Agency, Vancouver, BC;; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe 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.

methodsUsing 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.

resultsFrom 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.

conclusionsThe 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.

Indexed as

chemotherapycostsend-of-life carepalliative careSystemic therapy

Identifiers

PMID26985144
PMCPMC4780587

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.