{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:43:54Z","timestamp":1792637034653,"version":"4.5.0"},"reference-count":34,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Cancer patients and their families experience considerable financial hardship; however, the current published literature on the economic burden of cancer at the population level has typically focused on the costs from the health system\u2019s perspective. This study aims to estimate the economic burden of cancer in Canada from a societal perspective. The analysis was conducted using the OncoSim-All Cancers model, a Canadian cancer microsimulation model. OncoSim simulates cancer incidence and deaths using incidence and mortality data from the Canadian Cancer Registry and demography projections from Statistics Canada. Using a phase-based costing framework, we estimated the economic burden of cancer in Canada in 2021 by incorporating published direct health system costs and patients\u2019 and families\u2019 costs (out-of-pocket costs, time costs, indirect costs). From a societal perspective, cancer-related costs were CAD 26.2 billion in Canada in 2021; 30% of costs were borne by patients and their families. The economic burden was the highest in the first year after cancer was diagnosed (i.e., initial care). During this time, patients and families\u2019 costs amounted to almost CAD 4.8 billion in 2021. This study provides a comprehensive estimate of the economic burden of cancer, which could inform cost\u2013benefit analyses of proposed cancer prevention interventions.<\/jats:p>","DOI":"10.3390\/curroncol29040223","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T21:44:06Z","timestamp":1649972646000},"page":"2735-2748","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["The Economic Burden of Cancer in Canada from a Societal Perspective"],"prefix":"10.3390","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0821-1294","authenticated-orcid":false,"given":"Roxanne","family":"Garaszczuk","sequence":"first","affiliation":[{"name":"The Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean H. E.","family":"Yong","sequence":"additional","affiliation":[{"name":"The Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1242-1737","authenticated-orcid":false,"given":"Zhuolu","family":"Sun","sequence":"additional","affiliation":[{"name":"The Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3961-6008","authenticated-orcid":false,"given":"Claire","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"The Canadian Partnership Against Cancer, Toronto, ON M5H 1J8, Canada"},{"name":"Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada"},{"name":"Centre for Health Economics and Hull York Medical School, University of York, Heslington, York YO10 5DD, UK"},{"name":"Centre for Addiction and Mental Health, Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Toronto, ON M6J 1H4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"The Public Health Agency of Canada (2021). Release notice\u2014Canadian Cancer Statistics 2021. Health Promot. Chronic Dis. Prev. Can., 41, 399.","DOI":"10.24095\/hpcdp.41.11.09"},{"key":"ref_2","first-page":"151","article-title":"Trends in use and cost of initial cancer treatment in Ontario: A population-based descriptive study","volume":"1","author":"Bremner","year":"2013","journal-title":"Can. Med. Assoc. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1002\/cam4.657","article-title":"The cost of cancer: A retrospective analysis of the financial impact of cancer on young adults","volume":"5","author":"Landwehr","year":"2016","journal-title":"Cancer Med."},{"key":"ref_4","unstructured":"Mahon, K. (2020). The Financial Impact of Cancer in Canadian Young Adults. [Master\u2019s Thesis, Memorial University of Newfoundland]."},{"key":"ref_5","first-page":"E1","article-title":"The economic burden of cancer care in Canada: A population-based cost study","volume":"6","author":"Bremner","year":"2018","journal-title":"Can. Med. Assoc. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s40258-020-00619-z","article-title":"The indirect cost burden of cancer care in Canada: A systematic literature review","volume":"19","author":"Iragorri","year":"2021","journal-title":"Appl. Health Econ. Health Policy"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.3390\/curroncol28020117","article-title":"The out-of-pocket cost burden of cancer care\u2014A systematic literature review","volume":"28","author":"Iragorri","year":"2021","journal-title":"Curr. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1002\/pon.5516","article-title":"The psychosocial cost burden of cancer: A systematic literature review","volume":"29","author":"Essue","year":"2020","journal-title":"Psycho-oncology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3377","DOI":"10.1007\/s00520-020-05907-x","article-title":"Patient and family financial burden associated with cancer treatment in Canada: A national study","volume":"29","author":"Longo","year":"2021","journal-title":"Support Care Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"de Oliveira, C., Pataky, R., Bremner, K.E., Rangrej, J., Chan, K.K.W., Cheung, W.Y., Hoch, J.S., Peacock, S., and Krahn, M.D. (2016). Phase-specific and lifetime costs of cancer care in Ontario, Canada. BMC Cancer, 16.","DOI":"10.1186\/s12885-016-2835-7"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1093\/jnci\/djn103","article-title":"Cost of care for elderly cancer patients in the United States","volume":"100","author":"Yabroff","year":"2008","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1097\/01.mlr.0000167177.45020.4a","article-title":"Estimating patient time costs associated with colorectal cancer care","volume":"43","author":"Yabroff","year":"2005","journal-title":"Med. Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1093\/jnci\/djab192","article-title":"Annual report to the nation on the status of cancer, part 2: Patient economic burden associated with cancer care","volume":"113","author":"Yabroff","year":"2021","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1007\/s11764-010-0125-y","article-title":"The out of pocket cost of breast cancer survivors: A review","volume":"4","author":"Pisu","year":"2010","journal-title":"J. Cancer Surviv."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s11764-013-0305-7","article-title":"Patient time and out-of-pocket costs for long-term prostate cancer survivors in Ontario, Canada","volume":"8","author":"Bremner","year":"2014","journal-title":"J. Cancer Surviv."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1177\/0269216315583620","article-title":"Palliative care costs in Canada: A descriptive comparison of studies of urban and rural patients near end of life","volume":"29","author":"Dumont","year":"2015","journal-title":"Palliat. Med."},{"key":"ref_17","unstructured":"Statistics Canada (2022, January 12). Table 14-10-0134-01. Average Weekly Earnings, Average Hourly Wage Rate and Average Usual Weekly Hours by Union Status, Annual. Available online: https:\/\/www150.statcan.gc.ca\/t1\/tbl1\/en\/tv.action?pid=1410013401."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1002\/hec.3342","article-title":"The long-term effects of cancer on employment and earnings","volume":"26","author":"Jeon","year":"2017","journal-title":"J. Health Econ."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1200\/JCO.2016.70.1474","article-title":"Integration of palliative care into standard oncology care: American society of clinical oncology clinical practice guideline update","volume":"35","author":"Ferrell","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1056\/NEJMoa1000678","article-title":"Early palliative care for patients with metastatic non-small-cell lung cancer","volume":"363","author":"Temel","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_21","unstructured":"Statistics Canada (2022, January 12). Table 18-10-0004-13 Consumer Price Index by Product Group, Monthly, Percentage Change, Not Seasonally Adjusted, Canada, Provinces, Whitehorse, Yellowknife, and Iqaluit. Available online: https:\/\/www150.statcan.gc.ca\/t1\/tbl1\/en\/tv.action?pid=1810000413&pickMembers%5B0%5D=1.2&cubeTimeFrame.startMonth=10&cubeTimeFrame.startYear=2021&referencePeriods=20211001%2C20211001."},{"key":"ref_22","unstructured":"Statistics Canada (2022, January 12). Table 14-10-0060-01. Retirement Age by Class of Worker, Annual. Available online: https:\/\/www150.statcan.gc.ca\/t1\/tbl1\/en\/tv.action?pid=1410006001."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1093\/jnci\/dji171","article-title":"Employment outcomes of men treated for prostate cancer","volume":"97","author":"Bradley","year":"2005","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1007\/s10926-006-9057-9","article-title":"Enhanced provider communication and patient education regarding return to work in cancer survivors following curative treatment: A pilot study","volume":"16","author":"Nieuwenhuijsen","year":"2006","journal-title":"J. Occup. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/00005650-199101000-00004","article-title":"Estimating the treatment costs of breast and lung cancer","volume":"29","author":"Baker","year":"1991","journal-title":"Med. Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1111\/hsc.12170","article-title":"Societal costs of home and hospital end-of-life care for palliative care patients in Ontario, Canada","volume":"23","author":"Yu","year":"2015","journal-title":"Health Soc. Care Community"},{"key":"ref_27","unstructured":"Public Health Agency of Canada (2014). Economic Burden of Illness in Canada, 2005\u20132008."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/JOM.0000000000001242","article-title":"The economic burden of bladder cancer due to occupational exposure","volume":"60","author":"Jung","year":"2018","journal-title":"J. Occup. Environ. Med."},{"key":"ref_29","unstructured":"Canadian Partnership Against Cancer (2010). The Economic Burden of Skin Cancer in Canada: Current and Projected Final Report, Canadian Partnership Against Cancer."},{"key":"ref_30","unstructured":"Ontario Lung Association (2022, January 17). Life and Economic Burden of Lung Disease in Ontario: 2011 to 2041. Available online: https:\/\/books.google.ca\/books\/about\/Life_and_Economic_Burden_of_Lung_Disease.html?id=nppcAQAACAAJ&redir_esc=y."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1080\/15459624.2018.1447118","article-title":"The economic burden of occupational non-melanoma skin cancer due to solar radiation","volume":"15","author":"Mofidi","year":"2018","journal-title":"J. Occup. Environ. Hyg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1007\/s00520-006-0088-8","article-title":"Financial and family burden associated with cancer treatment in Ontario, Canada","volume":"14","author":"Longo","year":"2006","journal-title":"Support Care Cancer"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1093\/jnci\/92.3.269","article-title":"Travel distance to radiation therapy and receipt of radiotherapy following breast-conserving surgery","volume":"92","author":"Athas","year":"2000","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1146\/annurev.publhealth.22.1.91","article-title":"The burden of illness in cancer: Economic cost and quality of life","volume":"22","author":"Brown","year":"2001","journal-title":"Ann. Rev. Public Health"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/4\/223\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:53:53Z","timestamp":1760136833000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/4\/223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,14]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["curroncol29040223"],"URL":"https:\/\/doi.org\/10.3390\/curroncol29040223","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,14]]}}}