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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): We will accrue all patients with newly diagnosed lung or colon cancer receiving their care in one of five geographically diverse sites in the Cancer Research Network, an NCI-funded research consortium of HMOs. Automated data for all patients (2,058 patients with lung cancer over the two year enrollment period, and 1,732 patients with colon cancer over the two year enrollment period) will be supplemented with data obtained from complete medical record review and patient surveys for a sample of 1,424 patients with newly diagnosed lung cancer and 1,222 patients with newly diagnosed colon cancer. We will oversample African-Americans, Asians and Pacific Islanders, as well as Medicaid recipients. In addition, we will assemble an inception cohort of patients with newly diagnosed metastatic recurrences of colorectal cancer during the two-year enrollment period (projected at approximately 300 patients) for comprehensive data collection. We propose to lead analyses of CanCORS-wide core data in order to (1) examine the effect of race and ethnicity on patterns of care, treatment choice, quality of life, symptom control, and satisfaction; (2) characterize the types of providers seen by patients and examine the associations between provider characteristics/attitudes and patterns of care and outcomes; (3) evaluate the relationship between the structure/function of cancer care in the health care delivery systems of participating patients and patient outcomes, including health status, patient satisfaction, and cost; and (4) generate estimates of utility weights and time- and out-of-pocket costs that are disease- and treatment-specific for use in future cost-effectiveness analyses. Finally, in a Special Research Study we will aggregate cost data for CRN CanCORS subjects in order to (1) determine cancer-attributable phase-specific and lifetime costs of care for colorectal and lung cancer; (2) determine the proportion of total cancer-attributable costs that are spent on initial therapy versus second- and third line therapies for each cancer, stratified by stage at diagnosis; and (3) determine the relationship between type of initial therapy and the subsequent lifetime cancer-attributable costs of care.