Grant: Operating Grant: PHSI for Cancer Control

Gastrointestinal (GI) cancers account for nearly 25% of all cancers diagnosed each year. Depending on the type of cancer, between 20-80% of cancers are incurable at the time of diagnosis. Patients with advanced GI cancer may be offered a range of cancer-directed treatments aimed at improving the quality and quantity of life but without the possibility of cure, including surgery, chemotherapy, radiation-therapy, as well as supportive care measures such as pain control. While some of these treatments are beneficial for patients, some are ineffective and costly. These treatments can negatively affect the patient's experience, as well as the sustainability of the Canadian healthcare system. Our study aims to use healthcare data collected from a recent cohort of Ontario GI cancer patients, as well as speak directly with patients, physicians, and policy-makers to understand variation in clinical, patient-centered, and economic outcomes, and set priorities for improving advanced GI cancer care. We will pay careful attention to the cancer care provided to patients who may be vulnerable to experiencing worse outcomes, such as the elderly, those with a mental illness, and recent immigrants to Canada. This study will combine newly available province-wide data sources, including a patient-reported symptom screening tool and a novel Cancer Costing Algorithm. Our study will be structured into 3 phases. In phase I, we will conduct focus groups with patients, caregivers, physicians, and policy-makers to define needs and priorities advanced GI cancer care. Phase II will comprise systematic analysis of clinical, economic, and patient-reported outcomes for all advanced GI patients in Ontario from 2010-2016. In phase III we will share Phase I and II output with patients, physicians, and policy-makers in a second round of focus groups to determine how these routinely collected data may be leveraged to improve person-centered, sustainable care provided in the Canadian cancer system.