The Initiative to Maximize Progress in Adolescent and Young Adult Cancer Therapy (IMPACT) Cohort Study: a population-based cohort of young Canadians with cancer

BMC Cancer

Nancy N Baxter⁵  Corinne Daly²  Sumit Gupta¹  Jason D Pole⁴  Rinku Sutradhar³  Mark L Greenberg⁴  Paul C Nathan¹ 

[1] The Hospital for Sick Children, Toronto, Canada

[2] Department of Surgery, St. Michael’s Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada

[3] Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

[4] Pediatric Oncology Group of Ontario, Toronto, Canada

[5] Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

关键词: Population-based;    Cohort;    Survival;    Recurrence;    Treatment;    Cancer;    Young adults;    Adolescents;   

Others  :  1120933
DOI  :  10.1186/1471-2407-14-805

 received in 2014-05-02, accepted in 2014-10-21,  发布年份 2014

【 摘 要 】

Background

Cancer is the leading cause of disease-related death in adolescents and young adults (AYA). Annual improvements in AYA cancer survival have been inferior to those observed in children and older adults. Prior studies of AYA with cancer have been limited by their focus on patients from select treatment centres, reducing generalizability, or by being population-based but lacking diagnostic and treatment details. There is a critical need to conduct population-based studies that capture detailed patient, disease, treatment and system-level data on all AYA regardless of treatment location.

Methods/Design

We will create a cohort of all AYA (aged 15–21 years) at the time of diagnosis with any malignancy between 1992 and 2011 in Ontario, Canada (n = 5,394). Subjects will be identified through the Ontario Cancer Registry and the final cohort will be expanded to include 2012 diagnoses, as these data become available. Detailed diagnostic, treatment and outcome data for those patients treated at a pediatric cancer centre will be provided by a population-based pediatric cancer registry (n = 1,030). For 15–18 year olds treated at adult centres (n = 923) and all 19–21 year olds (n = 3396), trained abstractors will collect the comparable data elements from medical records. We will link these data to population-based administrative health data that include physician billings, hospitalizations and emergency room visits. This will allow descriptions of health care access and use prior to cancer diagnosis, and during and after treatment.

Discussion

The IMPACT cohort will serve as a platform for addressing questions that span the AYA cancer journey. These will include determining which factors influence where AYA receive care, the impact of locus of care on the types and intensity of cancer therapy, appropriateness of surveillance for disease recurrence, access to clinical trials, and receipt of palliative and survivor care. Findings using the IMPACT cohort have the potential to lead to changes in practice and cancer policy, reduce mortality, and improve quality of life for AYA with cancer. The IMPACT data platform will be a permanent resource, accessible to researchers across Canada.

【 授权许可】

   
2014 Baxter et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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