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Health State Descriptions for Canadians
82-619-MIE

Cancers

Context

Introduction

Summary table

The cancers

At diagnosis

Therapeutic options

Subsequent health states

References

Download chapter (PDF)

More information

Context: Health state descriptions for Canadians

This document provides standardized descriptions for the main health states associated with the progression and treatment of a disease. These descriptions are the first step in measuring how living with a disease and its treatment affects health-related quality of life in terms of physical, mental, and social well-being.

Underlying this approach is a new tool to measure functional health. Among other attributes, pain, limitations to physical functioning, or anxiety can limit an individual’s ability to participate in day-to-day activities. We use the Classification and Measurement System of Functional Health (CLAMES), with eleven such attributes that span physical, social and mental well-being. For each of these, there are four or five levels ranging in severity from no limitations in the attribute to severe limitations. Level 1, for instance, represents no limitations; for the attribute describing pain and discomfort it would read “generally free of pain and discomfort.” Table 1 shows the complete list of levels for each attribute.

For each health state from initial diagnosis to remission or palliation, we describe a “typical” case based on literature review and clinical experience. Although each individual will have a unique experience, these general descriptions are needed to measure health at the population level.

These descriptions were used to elicit preference scores from panels of Canadians based on techniques grounded in utility theory. Preference scores, which indicate the relative preference for a health state compared with full health, help us understand how Canadians view the various aspects of functional health. Along with data on incidence and duration, preference scores contribute to estimates of the impact on the Canadian population of both disease and risk factors that contribute to them.

Measured in terms of years of life lost and year-equivalents of reduced functioning due to the disease these estimates allow us to determine how many years of life—and how many years of healthy living—are lost due to specific diseases and risk factors. They provide answers to questions such as “what would be the impact of reducing obesity on the health of Canadians?” both in terms of lives saved and in terms of increased health over their lifespan.

This document is one of a series that covers the major disease groupings that affect Canadians. The series is primarily intended to document the disease classifications used in the Population Health Impact of Disease in Canada (PHI) research program and help researchers to understand how the PHI estimates were calculated. It is also of interest to health professionals, advocacy groups, and individual Canadians who are looking for an overview of how living with cancer affects day-to-day functioning throughout its various stages of progression and treatment.

More information on the PHI research program and the development of these estimates is available at http://www.phac-aspc.gc.ca/phi-isp/index.html.


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