Oncology · 6 h ago
Cancer symptom burden linked to treatment and ancillary care costs
A population-based cohort study in Ontario examined 1,728,025 symptom assessments from 285,924 adults with cancer diagnosed between 2008 and 2019. Higher patient-reported symptom burden was associated with lower costs for cancer-directed treatment and higher costs for ancillary health services in the following 30 days.
- Analysis included 285,924 adults with cancer in Ontario.
- Higher symptom scores tracked with lower treatment costs.
- Ancillary care costs rose with greater symptom burden.
- Observational findings do not establish causation.
Researchers used linked population data from adults diagnosed with cancer in Ontario, Canada, between 2008 and 2019. The analysis included 1,728,025 Edmonton Symptom Assessment System (ESAS) assessments from 285,924 patients. They examined the association between symptom scores and total health care costs during the 30 days after each assessment, separating cancer-directed treatment from services such as emergency care, home care, and complex continuing care. Costs were analyzed using log-transformed linear regression models.
Tiredness, depression, and poor well-being were the most commonly reported symptoms. Patients with respiratory and head and neck cancers had the greatest burden of moderate to severe symptoms. Each 10-point increase in total ESAS score was associated with a 9.4% decrease in costs for cancer-directed treatment and an 18% increase in ancillary health care costs. The study also reported the highest median 30-day costs after assessment for gastrointestinal, breast, and central nervous system cancers: CAD $85,000, $81,000, and $78,000 per patient, respectively.
The findings describe associations, not evidence that symptom burden caused changes in treatment or utilization. The authors suggest proactive symptom management may support treatment delivery and reduce ancillary resource use, but the study does not test that approach or establish its effect on costs or outcomes.
In practice
In this Ontario cohort, higher ESAS symptom burden was associated with lower costs for cancer-directed therapies and higher use-related costs for ancillary services in the 30 days after assessment. These findings support attention to symptom burden as a marker of treatment and supportive-care needs, but do not show that symptom management would increase treatment delivery or reduce costs. The study is observational, so the associations should not be used to infer causation or change care on their own.
AI-generated clinical interpretation · Not editor-reviewed
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Journal of Clinical Oncology: Association Between Patient-Reported Outcomes and Health Care Resource Utilization: Toward Developing Patient-Centered Value Measures in Cancer Care ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.