CMAJ OPEN, 1(4) E151 Research CMAJ OPENT he incidence of cancer in Canada has increased recently owing to population growth and aging. 1This increased incidence, in addition to the increased use of expensive new drugs and technologies to treat cancer, has led to a rise in cancer-related expenditures, which consume a growing share of limited health care budgets. [2][3][4] Previous studies have shown that many cancer-related costs are incurred in the year after diagnosis. [5][6][7] However, which resources and health services contribute most to the overall cost and whether rising prices or increased use can explain increased expenditures is not yet fully understood.We examined temporal trends in use of health care resources and costs for melanoma, breast cancer (in women only), testicular cancer and thyroid cancer among patients aged 19-44 years, and for breast (in women only), prostate, lung and colorectal cancers among patients aged 45 years and older to understand how patterns of care and associated costs for these cancers have changed. Our age cut-offs are based on previous work because there is no standard international definition of "young adult"; 8 our rationale is that young adulthood stretches from the end of adolescence to the start of menopause, in which the latter is known to induce marked changes in the cancer profile of women. 8 We chose these types of cancer because they account for about 60% of all cancers in each of the age groups included in our study. We sought to identify current cancer care needs to help predict trends in cancer care use and expenditures. Background: Cancer incidence and treatment-related costs are rising in Canada. We estimated health care use and costs in the first year after diagnosis for patients with 7 common types of cancer in Ontario to examine temporal trends in patterns of care and costs.

Objective. Little is known about the burden of osteoarthritis (OA) in Canada. This study was undertaken to estimate the excess burden of OA in Ontario, the largest province in Canada.Methods. The records of Ontarian respondents to the Canadian Community Health Survey (CCHS) who provided consent to data linkage were linked to the Ontario Health Insurance Program physician claims database and the Discharge Abstract Database Inpatient and Day Procedure databases. Patients with OA (n ‫؍‬ 1,474) were identified using CCHS 1.1 and the physician claims database. To determine the excess burden of OA, a control group matched by age, sex, and rural/urban status was created, with 3 controls per case (n ‫؍‬ 4,422). Sociodemographic and medical characteristics, health-related quality of life, and 1-year physician, day (outpatient) procedure, and hospitalization costs were compared between the 2 groups. Regression analyses were performed to identify predictors of medical characteristics, health utility, and cost.Results. The mean age of the OA patients and the control subjects was 66 years, and 74% of all study subjects were women. Several differences were observed between patients with OA and subjects without OA in terms of socioeconomic and medical characteristics. On a scale of 0-1, the mean utility value associated with OA was 0.68, compared to 0.84 for the control group (P < 0.0001), representing a utility decrement of 0.16. The 1-year physician, outpatient procedure, and hospitalization costs were significantly higher in the OA group than in the non-OA group ($2,233 Canadian versus $1,033 Canadian, respectively; P < 0.0001). Conclusion. These results indicate that the excess burden of OA in Ontario is considerable.According to the World Health Organization, 9.6% of men and 18.0% of women older than 60 years of age worldwide have symptomatic osteoarthritis (OA) (1), making OA one of the most prevalent chronic diseases. OA is also a major source of pain and severely impacts the health-related quality of life (HRQOL) and productivity of affected individuals. Almost 80% of patients with OA have some limitations in movement, and 25% cannot perform their usual daily activities (1). When preference-based instruments are used to measure HRQOL, patients with OA have a lower HRQOL than individuals with many other chronic diseases, including chronic obstructive pulmonary disease, low blood pressure, and irritable bowel syndrome (2). In a previous review of health utility scores associated with OA, baseline utility values were found to be low, ranging from 0.44 to 0.61 (on scale of 0-1, where 0 represents death and 1 represents perfect health) in randomized and nonrandomized studies (3).In addition to being a major source of disability, OA represents a considerable economic burden from both a payor and a societal perspective. Although several studies have shown that OA places a large burden on societies, large variations in cost estimates have been reported between studies and within countries. For example, a systematic review

BackgroundObesity is today’s principal neglected public health problem, as a rising proportion of adults will succumb to the medical complications of obesity. However, little is known about the burden of obesity in adults living in Ontario.ObjectivesTo present an overview of the human and economic burden associated with BMI categories in Ontario, Canada, in terms of socio-demographics, comorbidities, health-related quality of life (HRQoL) and costs associated with hospitalization, same day procedures and physician visits.MethodsThe records of all Ontarians who participated in the Canadian Community Health Survey (CCHS), cycle 1.1 and provided consent to data linkage were linked to three administrative databases. Socio-demographic variables, medical characteristics, HRQoL, one year hospitalization, day procedure and physician costs were described per BMI category. Regression analyses were conducted to identify predictors of medical characteristics, HRQoL and costs.ResultsMore than 50% of adult participants were either overweight or obese in 2000/2001. Obese adults, and to a lesser extent overweight adults, were more likely to report physician-diagnosed comorbid conditions, to use medications, and to have a lower HRQoL. After covariate adjustment, the hospitalization and physician costs were respectively 40% and 22% higher among obese and overweight adults than among normal-weight adults. No statistical cost differences were observed between normal and underweight individuals or between normal and overweight individuals. HRQoL was significantly lower in underweight and obese adults when compared to normal-weight individuals.ConclusionsDue to the large human and economic burden associated with under- or excess-weight, policies promoting healthy weight should remain a priority for governments and employers.