It is paramount that an accurate assessment of the impact of a cancer diagnosis is available with which to plan future resource allocation and to highlight the area to direct future policy initiatives.
In the second chapter I take a modelling approach to estimate the economic burden of bladder cancer due occupational exposure. Using a multi-stage Markov model, I estimate direct, indirect, and intangible lifetime costs of bladder cancer starting in the year 2011. The results of this analysis indicate that there is a substantial economic burden associated with occupational bladder cancer. Of the three components that make up the total economic costs, intangible costs represent the largest proportion, followed by indirect and direct costs.
In the third chapter, I use a data set created via a linkage of several administrative data resources to estimate the relationship between cancer diagnosis and annual labour market earnings. Using the Mahalanobis' distance and propensity score matching combined with a difference-in-difference regression, I isolate the impact of cancer diagnosis on labour market earnings of cancer survivors by comparison to their peers without cancer. There are two conclusions that can be derived from the results. First, I found that cancer survivors recover a fraction of their labour market earnings over time as they are further removed from the time of the cancer diagnosis. Secondly, I found the heterogeneous effects of cancer where most cancer survivors showed a persistent loss of labour market earnings except breast, cervix, and skin cancer survivors in the less-active age group.
In the fourth chapter I examine the impact of cancer on health using three commonly used health indicators: life expectancy, Health Utility Index, and health-adjusted life expectancy. Specifically, I decomposed the differences between individuals with and without cancer in above-mentioned indicators by age and cancer type—considering all cancer types, then specifically breast, colorectal and prostate cancers. The results of the study indicate the heterogeneous effects of cancer on health outcomes and provide a repository of health outcome information that other researchers and policymakers can use. / Thesis / Doctor of Philosophy (PhD) / In 2017, there were approximately 206,200 new cancer diagnoses in Canada, and 1 in 2 Canadians are currently expected to develop cancer in their lifetime. The chances are that most Canadians may know someone—likely more than one person—who has been afflicted with cancer. As more Canadians are diagnosed with cancer and survive, researchers are increasingly trying to understand and describe the short- and longer-term impact of cancer on health and social role engagement (particularly paid work) of afflicted individual, with the intent of identifying ways to minimize adverse outcomes.
The following chapters investigate the impact of a cancer diagnosis on annual labour market earnings, health, and the aggregation of these and other impacts on the societal economic burden. Chapter 1 sets the context for the entire thesis and draw out the overall objectives and motivations of the work. In Chapter 2 I conduct a comprehensive costing evaluation to estimate the economic burden of occupational cancer, taking a societal perspective, and provide a detailed breakdown of items that contribute to the economic burdens of cancer. In Chapter 3 I estimate the change in labour market earnings due to cancer diagnosis over a period of 5 years to uncover the heterogeneous effects of cancer type on labour market earnings. Finally, in Chapter 4 I estimate the impact of cancer on health using three different health indicators. In Chapter 5 I summarize the findings and contributions of each study.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/24918 |
| Date | January 2019 |
| Creators | Jung, Young |
| Contributors | Longo, Christopher, Health Policy |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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