Background
Methods
Study design and setting
Data sources
Study variables
Estimates of the net cost of care for EAC patients: Matching cases and controls
Estimation of health care costs
Statistical analysis
Sensitivity analysis
Results
Characteristics of the study population
Variable | Initial Phase | Continuing Care Phase | Terminal Phase | |||
---|---|---|---|---|---|---|
Cases | Controls | Cases | Controls | Cases | Controls | |
N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | |
N | 1265 | 1265 | 632 | 632 | 3011 | 3011 |
Mean ± SD time spent (days) | 259 ± 130 | 360 ± 34 | 726 ± 691 | 1521 ± 892 | 242 ± 130 | 360 ± 36 |
Age group at index date (years) | ||||||
< 50 | 106 (8.4) | 106 (8.4) | 53 (8.4) | 53 (8.4) | 242 (8.0) | 242 (8.0) |
50–54 | 138 (10.9) | 138 (10.9) | 76 (12.0) | 76 (12.0) | 277 (9.2) | 277 (9.2) |
55–59 | 165 (13.0) | 165 (13.0) | 84 (13.3) | 84 (13.3) | 331 (11.0) | 331 (11.0) |
60–64 | 227 (17.9) | 227 (17.9) | 116 (18.4) | 116 (18.4) | 459 (15.2) | 459 (15.2) |
65–69 | 203 (16.1) | 203 (16.1) | 113 (17.9) | 113 (17.9) | 423 (14.1) | 423 (14.1) |
70–74 | 161 (12.7) | 161 (12.7) | 86 (13.6) | 86 (13.6) | 413 (13.7) | 413 (13.7) |
75–79 | 138 (10.9) | 138 (10.9) | 66 (10.4) | 66 (10.4) | 383 (12.7) | 383 (12.7) |
80–84 | 79 (6.3) | 79 (6.3) | 24 (3.8) | 24 (3.8) | 279 (9.3) | 279 (9.3) |
≥ 85 | 48 (3.8) | 48 (3.8) | 14 (2.2) | 14 (2.2) | 204 (6.8) | 204 (6.8) |
Gender | ||||||
Female | 198 (15.7) | 198 (15.7) | 86 (13.6) | 86 (13.6) | 499 (16.6) | 499 (16.6) |
Male | 1067 (84.4) | 1067 (84.4) | 546 (86.4) | 546 (86.4) | 2512 (83.4) | 2512 (83.4) |
Residence | ||||||
Urban | 1033 (81.7) | 1045 (82.6) | 518 (82.0) | 529 (83.7) | 2464 (81.8) | 2498 (83.0) |
Rural | 232 (18.3) | 220 (17.4) | 114 (18.0) | 103 (16.3) | 547 (18.2) | 513 (17.0) |
Income quintile | ||||||
Q1 (lowest) | 239 (18.9) | 250 (19.8) | 109 (17.3) | 118 (18.7) | 598 (19.9) | 636 (21.1) |
Q2 | 247 (19.5) | 251 (19.8) | 111 (17.6) | 121 (19.2) | 629 (20.9) | 616 (20.5) |
Q3 | 242 (19.1) | 228 (18.0) | 121 (19.2) | 108 (17.1) | 587 (19.5) | 566 (18.8) |
Q4 | 274 (21.7) | 278 (22.0) | 140 (22.2) | 139 (22.0) | 623 (20.7) | 646 (21.5) |
Q5 (highest) | 263 (20.8) | 258 (20.4) | 151 (23.9) | 146 (23.1) | 574 (19.1) | 547 (18.2) |
Ontario health region | ||||||
Erie St. Clair | 65 (5.1) | 65 (5.1) | 35 (5.5) | 37 (5.9) | 153 (5.1) | 149 (5.0) |
South West | 88 (7.0) | 89 (7.0) | 40 (6.3) | 42 (6.7) | 273 (9.1) | 275 (9.1) |
Waterloo Wellington | 72 (5.7) | 73 (5.8) | 31 (4.9) | 33 (5.2) | 174 (5.8) | 169 (5.6) |
Hamilton Niagara Haldimand Brant | 174 (13.8) | 178 (14.1) | 80 (12.7) | 84 (13.3) | 445 (14.8) | 450 (15.0) |
Central West | 51 (4.0) | 47 (3.7) | 31 (4.9) | 30 (4.8) | 101 (3.4) | 89 (3.0) |
Mississauga | 56 (4.4) | 57 (4.5) | 26 (4.1) | 26 (4.1) | 140 (4.7) | 145 (4.8) |
Toronto Central | 78 (6.2) | 82 (6.5) | 38 (6.0) | 40 (6.3) | 199 (6.6) | 207 (6.9) |
Central | 103 (8.1) | 103 (8.1) | 59 (9.3) | 59 (9.3) | 214 (7.1) | 215 (7.1) |
Central East | 138 (10.9) | 134 (10.6) | 72 (11.4) | 67 (10.6) | 342 (11.4) | 339 (11.3) |
South East | 94 (7.4) | 89 (7.0) | 48 (7.6) | 44 (7.0) | 210 (7.0) | 203 (6.7) |
Champlain | 168 (13.3) | 170 (13.4) | 83 (13.1) | 79 (12.5) | 338 (11.2) | 351 (11.7) |
North Simcoe Muskoka | 64 (5.1) | 70 (5.5) | 34 (5.4) | 40 (6.3) | 146 (4.9) | 155 (5.2) |
North East | 79 (6.3) | 78 (6.2) | 38 (6.0) | 35 (5.5) | 193 (6.4) | 194 (6.4) |
North West | 35 (2.8) | 30 (2.4) | 17 (2.7) | 16 (2.5) | 83 (2.8) | 70 (2.3) |
ADGs | ||||||
0 | 4 (0.3) | 4 (0.3) | 3 (0.5) | 3 (0.5) | 15 (0.5) | 15 (0.5) |
1–3 | 49 (3.9) | 49 (3.9) | 21 (3.3) | 21 (3.3) | 117 (3.9) | 117 (3.9) |
4–7 | 235 (18.6) | 235 (18.6) | 118 (18.7) | 118 (18.7) | 549 (18.2) | 549 (18.2) |
8–10 | 341 (27.0) | 341 (27.0) | 155 (24.5) | 154 (24.5) | 803 (26.7) | 803 (26.7) |
11+ | 636 (50.3) | 636 (50.3) | 335 (53.0) | 335 (53.0) | 1527 (50.7) | 1527 (50.7) |
Year of EAC diagnosis | ||||||
2003 | 118 (9.3) | 118 (9.3) | 59 (9.3) | 57 (9.3) | 284 (9.4) | 284 (9.4) |
2004 | 126 (10.0) | 126 (10.0) | 74 (11.7) | 74 (11.7) | 288 (9.6) | 288 (9.6) |
2005 | 97 (7.7) | 97 (7.7) | 63 (10.0) | 63 (10.0) | 279 (9.3) | 279 (9.3) |
2006 | 139 (11.0) | 139 (11.0) | 71 (11.2) | 71 (11.2) | 320 (10.6) | 320 (10.6) |
2007 | 122 (9.6) | 122 (9.6) | 64 (10.1) | 64 (10.1) | 297 (9.9) | 297 (9.9) |
2008 | 139 (11.0) | 139 (11.0) | 81 (12.8) | 81 (12.8) | 349 (11.6) | 349 (11.6) |
2009 | 165 (13.0) | 165 (13.0) | 90 (14.2) | 90 (14.2) | 386 (12.8) | 386 (12.8) |
2010 | 181 (14.3) | 181 (14.3) | 85 (13.5) | 85 (13.5) | 397 (13.2) | 397 (13.2) |
2011 | 178 (14.1) | 178 (14.1) | 45 (7.1) | 45 (7.1) | 411 (13.7) | 411 (13.7) |
Phase-specific health care costs and net costs of care
Service category | Initial Phase | Continuing Care Phase | Terminal Phase | |||
---|---|---|---|---|---|---|
Cases | Controls | Cases | Controls | Cases | Controls | |
Mean (95% CI) | Mean (95% CI) | Mean (95% CI) | Mean (95% CI) | Mean (95% CI) | Mean (95% CI) | |
N | 1285 | 2942 | 651 | 2870 | 3011 | 3011 |
Outpatient visits | $170 ($164–$177) | $16 ($15–$17) | $157 ($150–$165) | $40 ($38–$42) | $1263 ($1199–$1327) | $37 ($25–$49) |
Emergency department visits | $20 ($19–$22) | $3 ($3–$4) | $17 ($15–$18) | $8 ($7–$8) | $218 ($197–$240) | $11 ($8–$13) |
Same-day surgery | $32 ($30–$34) | $3 ($2–$3) | $35 ($32–$37) | $8 ($7–$8) | $170 ($156–$185) | $3 ($3–$3) |
Inpatient hospitalization | $491 ($452–$530) | $36 ($30–$42) | $404 ($357–$451) | $60 ($55–$66) | $5451 ($5084–$5818) | $154 ($109–$198) |
Medications | $63 ($58–$68) | $17 ($15–$18) | $65 ($58–$73) | $43 ($40–$46) | $247 ($231–$264) | $23 ($21–$25) |
Home care | $86 ($79–$93) | $7 ($6–$8) | $61 ($54–$68) | $14 ($12–$16) | $467 ($440–$494) | $17 ($8–$27) |
Continuing care | $5 ($1–$8) | $11 ($8–$14) | $4 (−$1–$8) | $22 ($17–$27) | $20 ($10–$29) | $23 ($14–$31) |
Long-term care | $9 ($5–$14) | $20 ($16–$24) | $8 ($2–$14) | $32 ($25–$38) | $43 ($31–$55) | $42 ($32–$53) |
Total cost | $1139 ($1079–$1199) | $122 ($110–$135) | $923 ($852–$995) | $254 ($232–$276) | $9004 ($8545–$9462) | $326 ($265–$387) |
Service category | Overall | Initial Phase | Continuing Care Phase | Terminal Phase |
---|---|---|---|---|
Mean (95% CI) | Mean (95% CI) | Mean (95% CI) | Mean (95% CI) | |
N | 6022 | 4227 | 3521 | 6022 |
Outpatient visits | $1279 ($1215–$1343) | $155 ($148–$162) | $117 ($109–$125) | $1226 ($1161–$1291) |
Emergency department visits | $209 ($188–$231) | $17 ($16–$18) | $9 ($8–$11) | $208 ($186–$230) |
Same-day surgery | $179 ($164–$193) | $29 ($27–$31) | $27 ($24–$30) | $167 ($153–$182) |
Inpatient hospitalization | $5501 ($5135–$5867) | $455 ($415–$494) | $343 ($296–$390) | $5297 ($4929–$5665) |
Medications | $207 ($190–$225) | $46 ($41–$51) | $22 ($14–$30) | $224 ($208–$240) |
Home care | $479 ($450 –$509) | $79 ($72–$86) | $47 ($39–$55) | $449 ($421–$478) |
Continuing care | -$32 (−$47– -$17) | -$7 (−$11– -$2) | -$18 (−$25– -$12) | -$3 (−$15–$9) |
Long-term care | -$44 (−$64– -$24) | -$11 (−$17– -$4) | -$24 (−$33– -$15) | $0 (−$15–$16) |
Total net costs | $9002 ($8547–$9456) | $1016 ($955–$1078) | $669 ($594–$743) | $8678 ($8217–$9139) |
Total net costs of care by stage at diagnosis and treatment for EAC
Cost category | Overall | Initial Phase | Continuing Care Phase | Terminal Phase | |||
---|---|---|---|---|---|---|---|
Meana (95% CI) | N (Cases) | Meana (95% CI) | N (Cases) | Meana (95% CI) | N (Cases) | Meana (95% CI) | |
Stage at EAC diagnosis | |||||||
Stage 0-I | $5094 ($2659–$7529) | 102 | $804 ($626–$982) | 64 | $646 ($481–$810) | 126 | $4249 ($1789–$6710) |
Stage II | $6192 ($5368–$7015) | 282 | $999 ($887–$1111) | 161 | $696 ($600–$791) | 416 | $5426 ($4574–$6277) |
Stage III | $7413 ($6679–$8147) | 273 | $1254 ($1142–$1366) | 136 | $708 ($565–$851) | 451 | $6652 ($5879–$7425) |
Stage IV | $9978 ($9093–$10,864) | 222 | $1010 ($887–$1134) | 74 | $620 ($461–$780) | 930 | $10,000 ($9106–$10,894) |
Type of EAC treatment | |||||||
Surgery alone | $7785 ($6667–$8903) | 361 | $996 ($856–$1135) | 215 | $868 ($690–$1046) | 533 | $6937 ($5802–$8071) |
Chemotherapy alone | $8607 ($7565–$9650) | 161 | $1109 ($935–$1282) | 86 | $590 ($466–$715) | 338 | $8168 ($7091–$9245) |
Radiotherapy alone | $7998 ($7095–$8901) | 228 | $1330 ($1187–$1474) | 118 | $630 ($518–$742) | 405 | $7285 ($6344–$8225) |
Surgery + chemotherapy | $5801 ($4751–$6850) | 81 | $1089 ($862–$1316) | 52 | $878 ($634–$1123) | 118 | $4832 ($3710–$5954) |
Surgery + radiotherapy | $12,417 ($2067–$22,767) | – | $1080 ($494–$1667) | – | $170 (−$200–$539) | 6 | $12,237 ($1541–$22,933) |
Chemotherapy + radiotherapy | $7671 ($6023–$9320) | 68 | $1129 ($909–$1350) | 40 | $846 ($650–$1042) | 109 | $6849 ($5107–$8590) |
Surgery + chemotherapy + radiotherapy | $4743 ($1755–$7731) | 7 | $1323 ($757–$1890) | – | $236 ($111–$362) | 7 | $3519 ($684–$6354) |
No treatment | $10,152 ($9431–$10,873) | 377 | $765 ($688–842) | 136 | $318 ($243–$393) | 1495 | $10,238 ($9512–$10,965) |
Predictors of total net costs of care in individuals diagnosed with EAC
Variable | Initial Phase | Continuing Care Phase | Terminal Phase | ||||||
---|---|---|---|---|---|---|---|---|---|
Estimate | 95% CI | P-value | Estimate | 95% CI | P-value | Estimate | 95% CI | P-value | |
N = 4178 | N = 3472 | N = 5972 | |||||||
Age group at index date (years)* | |||||||||
< 50 | Reference | Reference | Reference | ||||||
50–54 | 0.112 | − 0.121–0.343 | 0.343 | 0.303 | 0.087–0.518 | 0.006 | −0.038 | − 0.272–0.194 | 0.749 |
55–59 | − 0.011 | − 0.236–0.211 | 0.921 | 0.104 | − 0.106–0.311 | 0.328 | − 0.106 | − 0.331–0.117 | 0.355 |
60–64 | 0.022 | − 0.191–0.230 | 0.838 | 0.340 | 0.141–0.534 | 0.001 | 0.008 | − 0.205–0.216 | 0.942 |
65–69 | 0.162 | − 0.053–0.374 | 0.135 | 0.549 | 0.349–0.746 | < 0.001 | 0.006 | −0.210–0.217 | 0.960 |
70–74 | 0.156 | −0.063–0.372 | 0.158 | 0.751 | 0.548–0.951 | < 0.001 | 0.246 | 0.030–0.458 | 0.024 |
75–79 | − 0.041 | − 0.264–0.179 | 0.716 | 0.786 | 0.578–0.990 | < 0.001 | 0.220 | 0.001–0.435 | 0.047 |
80–84 | 0.184 | − 0.059–0.426 | 0.137 | 0.854 | 0.624–1.085 | < 0.001 | 0.238 | 0.004–0.470 | 0.045 |
≥ 85 | 0.273 | 0.003–0.549 | 0.049 | 0.992 | 0.730–1.260 | < 0.001 | 0.328 | 0.076–0.581 | 0.011 |
Gender | |||||||||
Male | Reference | Reference | Reference | ||||||
Female | 0.006 | −0.125–0.141 | 0.928 | 0.084 | − 0.041–0.213 | 0.193 | 0.041 | − 0.087–0.172 | 0.539 |
Residence | |||||||||
Urban | Reference | Reference | Reference | ||||||
Rural | −0.006 | − 0.133–0.124 | 0.924 | − 0.073 | − 0.194–0.052 | 0.246 | 0.001 | − 0.124–0.129 | 0.987 |
Birth country | |||||||||
Outside of Canada | Reference | Reference | Reference | ||||||
Canada | 0.006 | − 0.130–0.139 | 0.932 | 0.067 | −0.173–0.298 | 0.574 | 0.020 | −0.073–0.112 | 0.668 |
Income quintile† | |||||||||
Q1 (lowest) | − 0.040 | − 0.196–0.116 | 0.619 | 0.017 | − 0.131–0.164 | 0.822 | 0.141 | − 0.013–0.295 | 0.072 |
Q2 | −0.077 | − 0.234–0.079 | 0.331 | − 0.023 | − 0.172–0.125 | 0.758 | 0.213 | 0.059–0.366 | 0.007 |
Q3 | −0.091 | − 0.250–0.068 | 0.260 | − 0.067 | − 0.217–0.084 | 0.383 | 0.247 | 0.090–0.404 | 0.002 |
Q4 | 0.043 | −0.111–0.196 | 0.587 | 0.151 | 0.005–0.296 | 0.042 | 0.117 | −0.037–0.27 | 0.135 |
Q5 (highest) | Reference | Reference | Reference | ||||||
Ontario health region** | |||||||||
Central | Reference | Reference | Reference | ||||||
Erie St. Clair | −0.073 | −0.353–0.212 | 0.610 | 0.061 | −0.200–0.327 | 0.649 | 0.052 | −0.227–0.335 | 0.716 |
South West | −0.071 | − 0.316–0.174 | 0.571 | − 0.326 | − 0.557– − 0.097 | 0.005 | 0.173 | − 0.069–0.412 | 0.159 |
Waterloo Wellington | 0.085 | − 0.186–0.360 | 0.539 | −0.094 | − 0.351–0.166 | 0.475 | 0.214 | − 0.055–0.486 | 0.121 |
Hamilton Niagara Haldimand Brant | 0.048 | −0.174–0.265 | 0.666 | 0.011 | −0.198–0.216 | 0.917 | 0.062 | −0.160–0.279 | 0.579 |
Central West | 0.383 | 0.068–0.712 | 0.020 | 0.326 | 0.031–0.633 | 0.033 | 0.144 | −0.175–0.476 | 0.386 |
Mississauga | 0.018 | −0.266–0.309 | 0.901 | −0.090 | − 0.358–0.184 | 0.513 | 0.235 | − 0.048–0.523 | 0.106 |
Toronto Central | 0.046 | −0.214–0.308 | 0.729 | 0.328 | 0.082–0.576 | 0.009 | 0.291 | 0.032–0.551 | 0.028 |
Central East | −0.035 | − 0.267–0.194 | 0.767 | −0.060 | − 0.278–0.155 | 0.586 | 0.053 | − 0.179–0.281 | 0.651 |
South East | 0.051 | −0.206–0.309 | 0.696 | 0.049 | −0.193–0.292 | 0.692 | −0.085 | − 0.342–0.172 | 0.515 |
Champlain | 0.047 | −0.182–0.272 | 0.686 | 0.043 | −0.173–0.256 | 0.691 | 0.032 | −0.199–0.260 | 0.782 |
North Simcoe Muskoka | −0.025 | − 0.304–0.259 | 0.861 | − 0.014 | − 0.276–0.254 | 0.920 | 0.026 | − 0.252–0.309 | 0.855 |
North East | − 0.046 | − 0.308–0.218 | 0.732 | − 0.090 | − 0.337–0.158 | 0.474 | 0.245 | − 0.017–0.507 | 0.067 |
North West | 0.010 | − 0.338–0.379 | 0.957 | − 0.026 | − 0.359–0.329 | 0.884 | 0.164 | − 0.178–0.525 | 0.359 |
ADGs‡ | |||||||||
0 | Reference | Reference | Reference | ||||||
1–3 | 0.201 | −1.302–1.236 | 0.747 | 0.642 | −0.719–1.609 | 0.263 | −0.341 | −1.393–0.470 | 0.463 |
4–7 | 0.083 | −1.407–1.087 | 0.893 | 0.801 | −0.547–1.738 | 0.155 | −0.564 | − 1.595–0.212 | 0.212 |
8–10 | 0.211 | − 1.277–1.213 | 0.729 | 1.045 | − 0.301–1.980 | 0.063 | − 0.507 | − 1.537–0.265 | 0.259 |
11+ | 0.334 | − 1.153–1.334 | 0.584 | 1.504 | 0.159–2.436 | 0.008 | −0.472 | −1.501–0.297 | 0.293 |
Stage at EAC diagnosis§ | |||||||||
Stage 0-I | Reference | Reference | Reference | ||||||
Stage II | 0.191 | 0.006–0.371 | 0.040 | 0.054 | − 0.164–0.266 | 0.621 | 0.229 | 0.014–0.435 | 0.033 |
Stage III | 0.396 | 0.210–0.577 | < 0.001 | 0.067 | − 0.157–0.284 | 0.551 | 0.422 | 0.209–0.627 | < 0.001 |
Stage IV | 0.201 | 0.010–0.388 | 0.037 | −0.028 | − 0.277–0.219 | 0.823 | 0.814 | 0.613–1.006 | < 0.001 |
EAC treatment¶ | |||||||||
No treatment | Reference | Reference | Reference | ||||||
Surgery alone | 0.231 | 0.106–0.356 | < 0.001 | 0.673 | 0.512–0.832 | < 0.001 | −0.375 | − 0.485– − 0.263 | < 0.001 |
Chemotherapy alone | 0.327 | 0.170–0.489 | < 0.001 | 0.389 | 0.189–0.592 | < 0.001 | − 0.218 | − 0.349– − 0.084 | 0.001 |
Radiotherapy alone | 0.493 | 0.352–0.636 | < 0.001 | 0.435 | 0.251–0.619 | < 0.001 | −0.328 | − 0.450– − 0.203 | < 0.001 |
Surgery + chemotherapy | 0.312 | 0.108–0.524 | 0.003 | 0.682 | 0.447–0.925 | < 0.001 | − 0.717 | − 0.921– − 0.500 | < 0.001 |
Surgery + radiotherapy | 0.304 | − 0.700–1.799 | 0.620 | − 0.300 | −1.193–0.953 | 0.572 | 0.173 | − 0.610–1.228 | 0.705 |
Chemotherapy + radiotherapy | 0.344 | 0.126–0.574 | 0.003 | 0.653 | 0.396–0.923 | < 0.001 | −0.387 | − 0.598– − 0.162 | 0.001 |
Surgery + chemotherapy + radiotherapy | 0.488 | − 0.098–1.210 | 0.139 | − 0.154 | −1.047–1.098 | 0.771 | −1.011 | − 1.743– − 0.046 | 0.017 |
Year of EAC diagnosis€ | |||||||||
2003 | Reference | Reference | Reference | ||||||
2004 | 0.015 | −0.208–0.238 | 0.896 | 0.010 | −0.193–0.213 | 0.922 | −0.131 | − 0.352–0.090 | 0.245 |
2005 | −0.056 | − 0.285–0.174 | 0.633 | − 0.158 | − 0.365–0.049 | 0.134 | 0.064 | − 0.159–0.287 | 0.573 |
2006 | 0.401 | 0.183–0.619 | < 0.001 | 0.073 | − 0.129–0.273 | 0.478 | 0.033 | − 0.183–0.248 | 0.763 |
2007 | 0.292 | 0.069–0.514 | 0.010 | −0.053 | − 0.257–0.150 | 0.607 | 0.175 | − 0.044–0.394 | 0.117 |
2008 | 0.367 | 0.151–0.581 | 0.001 | −0.181 | − 0.377–0.014 | 0.069 | 0.351 | 0.139–0.561 | 0.001 |
2009 | 0.527 | 0.316–0.735 | < 0.001 | −0.274 | − 0.467– − 0.084 | 0.005 | 0.327 | 0.119–0.532 | 0.002 |
2010 | 0.462 | 0.253–0.668 | < 0.001 | −0.729 | − 0.922– −0.539 | < 0.001 | 0.310 | 0.103–0.514 | 0.003 |
2011 | 0.541 | 0.333–0.746 | < 0.001 | −1.723 | − 1.916– − 1.531 | < 0.001 | 0.222 | 0.016–0.425 | 0.033 |
Variable | Initial Phase | Continuing Care Phase | Terminal Phase | ||||||
---|---|---|---|---|---|---|---|---|---|
Estimate | 95% CI | P-value | Estimate | 95% CI | P-value | Estimate | 95% CI | P-value | |
Intercept | 6.012 | 5.588–6.461 | < 0.001 | 4.402 | 3.653–5.338 | < 0.001 | 7.718 | 7.176–8.288 | < 0.001 |
Age group at index date (years)* | |||||||||
< 50 | Reference | Reference | |||||||
50–54 | − 0.021 | − 0.243–0.200 | 0.853 | −0.024 | − 0.239–0.189 | 0.823 | |||
55–59 | − 0.102 | − 0.321–0.114 | 0.355 | −0.175 | − 0.385–0.033 | 0.099 | |||
60–64 | − 0.111 | − 0.317–0.092 | 0.289 | −0.004 | − 0.203–0.193 | 0.971 | |||
65–69 | 0.085 | − 0.127–0.295 | 0.428 | −0.100 | − 0.302–0.100 | 0.331 | |||
70–74 | 0.064 | −0.159–0.286 | 0.572 | 0.276 | 0.068–0.483 | 0.009 | |||
75–79 | −0.184 | − 0.409–0.041 | 0.109 | 0.125 | −0.086–0.334 | 0.242 | |||
80–84 | − 0.049 | − 0.315–0.221 | 0.718 | 0.040 | −0.190–0.271 | 0.732 | |||
≥ 85 | −0.377 | − 0.703– − 0.036 | 0.027 | 0.181 | − 0.113–0.484 | 0.235 | |||
Residence | |||||||||
Urban | Reference | ||||||||
Rural | −0.159 | −0.293– − 0.022 | 0.022 | ||||||
Income quintile† | |||||||||
Q1 (lowest) | 0.156 | −0.007–0.320 | 0.061 | ||||||
Q2 | −0.074 | −0.239–0.091 | 0.378 | ||||||
Q3 | −0.069 | − 0.232–0.094 | 0.406 | ||||||
Q4 | −0.112 | − 0.269–0.045 | 0.162 | ||||||
Q5 (highest) | Reference | ||||||||
Ontario health region** | |||||||||
Central | Reference | ||||||||
Erie St. Clair | 0.107 | −0.180–0.401 | 0.468 | 0.137 | − 0.148–0.425 | 0.348 | |||
South West | −0.181 | − 0.460–0.102 | 0.205 | 0.151 | − 0.098–0.397 | 0.233 | |||
Waterloo Wellington | −0.029 | − 0.326–0.277 | 0.851 | 0.356 | 0.089–0.623 | 0.009 | |||
Hamilton Niagara Haldimand Brant | 0.026 | −0.212–0.262 | 0.829 | 0.101 | − 0.122–0.317 | 0.369 | |||
Central West | 0.169 | −0.137–0.485 | 0.284 | −0.125 | − 0.471–0.238 | 0.488 | |||
Mississauga | 0.103 | −0.216–0.433 | 0.534 | 0.213 | −0.118–0.558 | 0.216 | |||
Toronto Central | 0.122 | −0.160–0.409 | 0.401 | 0.197 | −0.073–0.469 | 0.154 | |||
Central East | 0.076 | −0.165–0.315 | 0.537 | −0.080 | − 0.320–0.158 | 0.513 | |||
South East | −0.227 | − 0.491–0.039 | 0.093 | − 0.067 | − 0.319–0.182 | 0.598 | |||
Champlain | 0.200 | −0.035–0.432 | 0.093 | 0.117 | −0.117–0.346 | 0.322 | |||
North Simcoe Muskoka | −0.047 | − 0.333–0.245 | 0.747 | 0.030 | − 0.250–0.314 | 0.833 | |||
North East | −0.103 | − 0.387–0.188 | 0.483 | 0.396 | 0.124–0.670 | 0.004 | |||
North West | −0.537 | − 0.899– − 0.152 | 0.005 | 0.405 | 0.086–0.734 | 0.014 | |||
ADGs‡ | |||||||||
0 | Reference | ||||||||
1–3 | 1.619 | 0.659–2.408 | < 0.001 | ||||||
4–7 | 1.636 | 0.707–2.373 | < 0.001 | ||||||
8–10 | 1.712 | 0.788–2.442 | < 0.001 | ||||||
11+ | 1.897 | 0.975–2.623 | < 0.001 | ||||||
Stage at EAC diagnosis§ | |||||||||
Stage 0-I | Reference | Reference | |||||||
Stage II | 0.220 | 0.043–0.392 | 0.014 | 0.085 | −1.167–1.938 | 0.911 | |||
Stage III | 0.414 | 0.236–0.587 | < 0.001 | 0.900 | 0.461–1.315 | < 0.001 | |||
Stage IV | 0.325 | 0.135–0.511 | 0.001 | 1.697 | 0.640–3.143 | 0.006 | |||
EAC treatment¶ | |||||||||
No treatment | Reference | Reference | Reference | ||||||
Surgery alone | 0.237 | 0.087–0.386 | 0.002 | 0.658 | 0.500–0.815 | < 0.001 | −4.123 | −6.577– −0.977 | 0.001 |
Chemotherapy alone | 0.190 | 0.012–0.371 | 0.038 | 0.420 | 0.223–0.620 | < 0.001 | −1.309 | −3.154–0.547 | 0.150 |
Radiotherapy alone | 0.407 | 0.250–0.565 | < 0.001 | 0.513 | 0.334–0.693 | < 0.001 | −0.841 | −2.750–1.280 | 0.387 |
Surgery + chemotherapy | 0.423 | 0.185–0.671 | 0.001 | 0.590 | 0.362–0.824 | < 0.001 | −1.290 | −2.019– −0.464 | 0.001 |
Surgery + radiotherapy | 0.733 | −0.491–2.695 | 0.338 | −0.510 | −1.375–0.653 | 0.312 | − 0.038 | − 1.564–2.854 | 0.970 |
Chemotherapy + radiotherapy | 0.449 | 0.209–0.699 | < 0.001 | 0.617 | 0.368–0.876 | < 0.001 | −1.292 | −3.592–1.863 | 0.310 |
Surgery + chemotherapy + radiotherapy | 0.942 | 0.243–1.810 | 0.017 | −0.104 | − 0.974–1.061 | 0.837 | − 0.808 | −2.210–1.287 | 0.344 |
Year of EAC diagnosis€ | |||||||||
2003 | Reference | Reference | Reference | ||||||
2004 | 0.184 | − 0.212–0.555 | 0.346 | 0.012 | − 0.236–0.258 | 0.924 | −0.085 | − 0.459–0.267 | 0.647 |
2005 | 0.357 | −0.044–0.734 | 0.071 | 0.095 | −0.154–0.343 | 0.454 | 0.420 | 0.050–0.768 | 0.022 |
2006 | 0.615 | 0.229–0.973 | 0.001 | 0.355 | 0.108–0.600 | 0.005 | 0.342 | − 0.020–0.679 | 0.054 |
2007 | 0.379 | −0.010–0.742 | 0.047 | 0.276 | 0.026–0.525 | 0.030 | 0.473 | 0.108–0.814 | 0.009 |
2008 | 0.653 | 0.271–1.007 | 0.001 | 0.311 | 0.071–0.547 | 0.010 | 0.561 | 0.202–0.894 | 0.001 |
2009 | 0.815 | 0.433–1.168 | < 0.001 | 0.224 | −0.015–0.460 | 0.064 | 0.660 | 0.303–0.991 | < 0.001 |
2010 | 0.675 | 0.294–1.026 | < 0.001 | −0.099 | − 0.339–0.139 | 0.417 | 0.537 | 0.180–0.868 | 0.002 |
2011 | 0.878 | 0.495–1.231 | < 0.001 | −0.458 | − 0.735– − 0.178 | 0.001 | 0.531 | 0.169–0.869 | 0.003 |
Income quintile-Comorbidity interaction†† | |||||||||
Q1 (lowest)*ADGs | −0.036 | − 0.184–0.112 | 0.629 | ||||||
Q2*ADGs | −0.096 | − 0.165– − 0.027 | 0.006 | ||||||
Q3*ADGs | 0.017 | −0.041–0.077 | 0.563 | ||||||
Q4*ADGs | −0.063 | −0.111– − 0.016 | 0.009 | ||||||
Comorbidity-EAC stage interaction‡‡ | |||||||||
ADGs 1–3*EAC stage II | 1.132 | −0.820–2.588 | 0.173 | ||||||
ADGs 1–3*EAC stage III | −0.446 | −1.181–0.319 | 0.242 | ||||||
ADGs 1–3*EAC stage IV | −0.733 | −2.219–0.399 | 0.256 | ||||||
ADGs 4–7*EAC stage II | 0.274 | − 1.578–1.519 | 0.715 | ||||||
ADGs 4–7*EAC stage III | −0.090 | −0.482–0.304 | 0.652 | ||||||
ADGs 4–7*EAC stage IV | −0.479 | −1.903–0.530 | 0.424 | ||||||
ADGs 8–10*EAC stage II | 0.274 | −1.569–1.500 | 0.712 | ||||||
ADGs 8–10*EAC stage III | −0.269 | −0.610–0.072 | 0.122 | ||||||
ADGs 8–10*EAC stage IV | −0.821 | −2.239–0.176 | 0.168 | ||||||
ADGs 11 + *EAC stage II | 0.345 | −1.490–1.554 | 0.639 | ||||||
ADGs 11 + *EAC stage IV | −0.535 | −1.950–0.456 | 0.367 | ||||||
Comorbidity-EAC treatment interaction‡‡‡ | |||||||||
ADGs 1–3*Surgery alone | 4.145 | 0.983–6.626 | 0.001 | ||||||
ADGs 1–3*Chemotherapy alone | 0.885 | −1.062–2.881 | 0.364 | ||||||
ADGs 1–3*Radiotherapy alone | 1.126 | −1.021–3.076 | 0.256 | ||||||
ADGs 1–3*Surgery + chemotherapy | −1.279 | −3.018–1.679 | 0.238 | ||||||
ADGs 1–3*Chemotherapy + radiotherapy | 1.926 | −1.213–4.247 | 0.128 | ||||||
ADGs 4–7*Surgery alone | 3.650 | 0.514–6.087 | 0.004 | ||||||
ADGs 4–7*Chemotherapy alone | 1.304 | −0.444–3.054 | 0.126 | ||||||
ADGs 4–7*Radiotherapy alone | 1.135 | − 0.936–2.983 | 0.227 | ||||||
ADGs 4–7*Surgery + chemotherapy | −0.003 | − 0.684–0.729 | 0.993 | ||||||
ADGs 4–7*Surgery + radiotherapy | −1.133 | −4.416–2.149 | 0.433 | ||||||
ADGs 4–7*Chemotherapy + radiotherapy | 1.982 | −1.091–4.148 | 0.100 | ||||||
ADGs 4–7*Surgery + chemotherapy + radiotherapy | 0.274 | −1.907–2.458 | 0.792 | ||||||
ADGs 8–10*Surgery alone | 3.884 | 0.754–6.313 | 0.002 | ||||||
ADGs 8–10*Chemotherapy alone | 1.419 | −0.318–3.156 | 0.093 | ||||||
ADGs 8–10*Radiotherapy alone | 0.784 | −1.282–2.625 | 0.402 | ||||||
ADGs 8–10*Surgery + chemotherapy | 0.319 | −0.281–0.943 | 0.304 | ||||||
ADGs 8–10*Surgery + radiotherapy | 0.135 | −3.125–3.394 | 0.925 | ||||||
ADGs 8–10*Chemotherapy + radiotherapy | 2.654 | −0.410–4.800 | 0.027 | ||||||
ADGs 11 + *Surgery alone | 4.185 | 1.060–6.604 | 0.001 | ||||||
ADGs 11 + *Chemotherapy alone | 1.225 | −0.499–2.950 | 0.143 | ||||||
ADGs 11 + *Radiotherapy alone | 0.986 | −1.076–2.823 | 0.291 | ||||||
ADGs 11 + *Chemotherapy + radiotherapy | 2.253 | −0.808–4.395 | 0.059 | ||||||
EAC stage-EAC treatment interaction§§ | |||||||||
EAC stage II*Surgery alone | 0.107 | −0.446–0.668 | 0.706 | ||||||
EAC stage II*Chemotherapy alone | 0.031 | −0.819–0.814 | 0.940 | ||||||
EAC stage II*Radiotherapy alone | −0.161 | −0.814–0.476 | 0.622 | ||||||
EAC stage II*Surgery + chemotherapy | 0.667 | −0.294–1.576 | 0.158 | ||||||
EAC stage II*Chemotherapy + radiotherapy | −1.105 | −2.191– −0.146 | 0.031 | ||||||
EAC stage III*Surgery alone | −0.182 | −0.725–0.368 | 0.513 | ||||||
EAC stage III*Chemotherapy alone | −0.310 | −1.158–0.470 | 0.452 | ||||||
EAC stage III*Radiotherapy alone | −0.215 | − 0.861–0.415 | 0.506 | ||||||
EAC stage III*Surgery + chemotherapy | 1.146 | 0.194–2.038 | 0.014 | ||||||
EAC stage III*Chemotherapy + radiotherapy | −0.804 | −1.894–0.158 | 0.119 | ||||||
EAC stage III*Surgery + chemotherapy + radiotherapy | 0.397 | −1.813–2.610 | 0.707 | ||||||
EAC stage IV*Surgery alone | −0.091 | −0.664–0.497 | 0.759 | ||||||
EAC stage IV*Chemotherapy alone | −0.115 | −0.921–0.612 | 0.767 | ||||||
EAC stage IV*Radiotherapy alone | −0.135 | − 0.757–0.471 | 0.666 | ||||||
EAC stage IV*Surgery + chemotherapy | 1.315 | 0.326–2.272 | 0.008 | ||||||
EAC stage IV*Chemotherapy + radiotherapy | −1.162 | −2.233– −0.224 | 0.021 |