title: Patient time and out-of-pocket costs for long-term prostate cancer survivors in Ontario, Canada.
abstract: OBJECTIVE
  Time and out-of-pocket (OOP) costs can represent a substantial burden for cancer patients but have not been described for long-term cancer survivors. We estimated these costs, their predictors, and their relationship to financial income, among a cohort of long-term prostate cancer (PC) survivors.
  
  
  METHODS
  A population-based, community-dwelling, geographically diverse sample of long-term (2-13 years) PC survivors in Ontario, Canada, was identified from the Ontario Cancer Registry and contacted through their referring physicians. We obtained data on demographics, health care resource use, and OOP costs through mailed questionnaires and conducted chart reviews to obtain clinical data. We compared mean annual time and OOP costs (2006 Canadian dollars) across clinical and sociodemographic characteristics and examined the association between costs and four groups of predictors (patient, disease, system, symptom) using two-part regression models.
  
  
  RESULTS
  Patients' (N = 585) mean age was 73 years; 77 % were retired, and 42 % reported total annual incomes less than $40,000. Overall, mean time costs were $838/year and mean OOP costs were $200/year. Although generally low, total costs represented approximately 10 % of income for lower income patients. No demographic variables were associated with costs. Radical prostatectomy, younger age, poor urinary function, current androgen deprivation therapy, and recent diagnosis were significantly associated with increased likelihood of incurring any costs, but only urinary function significantly affected total amount.
  
  
  CONCLUSIONS
  Time and OOP costs are modest for most long-term PC survivors but can represent a substantial burden for lower income patients. Even several years after diagnosis, PC-specific treatments and treatment-related dysfunction are associated with increased costs.
  
  
  CONCLUSIONS
  Time and out-of-pocket costs are generally manageable for long-term PC survivors but can be a significant burden mainly for lower income patients. The effects of PC-specific, treatment-related dysfunctions on quality of life can also represent sources of expense for patients.
authors: Department of Social and Epidemiological Research, Centre for Addiction and Mental Health, 33 Russell Street, Room T414, Toronto, Ontario, M5S 2S1, Canada, claire.deoliveira@camh.ca.
authors: Claire
authors: C
authors: de Oliveira
authors: Karen E
authors: KE
authors: Bremner
authors: Andy
authors: A
authors: Ni
authors: Shabbir M H
authors: SM
authors: Alibhai
authors: Audrey
authors: A
authors: Laporte
authors: Murray D
authors: MD
authors: Krahn
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000191:economics* / Q000532:radiotherapy / Q000601:surgery; D000367:Age Factors; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017281:Cost of Illness; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data; D007172:Erectile Dysfunction / Q000191:economics / Q000209:etiology; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D019458:Insurance Coverage; D007410:Intestinal Diseases / Q000191:economics / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000191:economics / Q000453:epidemiology; D009864:Ontario / Q000453:epidemiology; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology; D011468:Prostatectomy / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000532:radiotherapy / Q000601:surgery; D011832:Radiation Injuries / Q000191:economics / Q000209:etiology; D012179:Retirement; D017741:Survivors / Q000706:statistics & numerical data*; D014555:Urination Disorders / Q000191:economics / Q000209:etiology
chemical_list: D000726:Androgen Antagonists; D000970:Antineoplastic Agents
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