The Effect of Locus of Care Upon Adolescent and Young Adults Cancer Outcomes: An IMPACT Cohort Study
As featured in the November 2015 ALSF e-newsletter:
Dr. Gupta's research examines the care of adolescents and young adults, ages 15-21, with cancer. Unfortunately, while survival rates in other groups of cancer patients have improved significantly, cancer survival rates in this age group have not kept pace. Care for adolescents and young adults with cancer takes place in a variety of facilities, including children's hospitals, adult cancer hospitals and community hospitals. Some studies have suggested that the type of hospital in which these young people are treated may affect the treatments they receive and how well they fare.
Studying this problem is challenging because it involves teasing out how the type of hospital influences variations in treatment, and accessing detailed patient and treatment information. Dr. Gupta is collecting this information and is building a database of all adolescents and young adults diagnosed with cancer in Ontario over a 20 year period, along with their treatments and outcomes.
If he finds that treatments and outcomes differ, Dr. Gupta's goal is to develop policy recommendations to standardize practices for treating young people in this age group to ensure that every adolescent and young adult with cancer receives the most effective treatments and best possible care.
More adolescents and young adults (AYA) die from cancer than from any other disease. Unfortunately, while survival rates in other groups of cancer patients have improved significantly, cancer survival rates in AYA have not kept pace. Right now, AYA with cancer are treated in many different kinds of hospitals including children's hospitals, adult cancer hospitals and community hospitals. Some studies have suggested that where AYA are treated may affect the type of treatment they get and their chances of survival.
Unfortunately, these studies have been limited. Some studies have only looked at AYA who were treated in specialized hospitals, ignoring AYA treated in community hospitals. Other studies been unable to access the detailed patient and treatment information necessary to understand the problem in depth.
In order to overcome these limitations and improve AYA cancer care and survival, we are building the IMPACT cohort by collecting detailed patient, disease and treatment information on every AYA diagnosed with cancer in Ontario, Canada over a 20 year period.
Using the IMPACT cohort, we will study AYA with the most common forms of cancer in order to determine whether these patients receive different care in different hospital types, and if so, whether these treatment variations lead to differences in survival. The results of our study will help to create treatment guidelines for AYA with cancer and may also help design policies addressing where AYA with cancer should be treated. Thus our study results will ultimately lead to improved survival for AYA with cancer.