TIME TOXICITY IN CANCER CARE AND TIME SPENT IN HEALTHCARE ACROSS CANCER AND TREATMENT TYPES IN FINLAND
Author(s)
Samuli Tuominen, MSc, Bettina Mannerström, PhD, Mariann Lassenius, PhD, Riikka Mattila.
Medaffcon Oy, Espoo, Finland.
Medaffcon Oy, Espoo, Finland.
OBJECTIVES: Time toxicity (TT), defined as time spent in contact with healthcare captures the care-related time burden experienced by patients. This real-world study describes TT by cancer type and treatment modality in Finland.
METHODS: This retrospective registry-based cohort study included secondary data of adult patients treated for breast (n=9,071), lung (n=2,380), urothelial (n=725), kidney cancer (n=1,111), or melanoma (n=3,667) during 2018-2024 in the Helsinki and Uusimaa region, covering 1.8 million inhabitants. Treatment modality was defined hierarchically based on treatments received during the first follow-up year. Immune-oncological (IO) therapies were considered first, then tyrosine-kinase inhibitors (TKI), chemotherapies (CT) in general, and lastly resection of primary tumor (no systemic treatment). TT was assessed via negative binomial regression and estimated marginal means while adjusting for sex, age and receipt of radiotherapy.
RESULTS: Overall first year TT was 39 days. Across cancer types, patients receiving IO therapy spent 24% more days in healthcare contact than those receiving chemotherapy, while TKI therapy and resection without systemic treatment were associated with 15% and 46% fewer days, respectively. TT varied by cancer type with lung cancer associated with 10% more days in healthcare contact than breast cancer, while melanoma, kidney, and urothelial cancers were associated with 46%, 10%, and 7% fewer days, respectively. Highest TT was observed among patients with lung cancer receiving IO therapy with 97 days in the first year (on average 2 days per week) while the lowest was observed among patients with resected melanoma without systemic treatment at 15 days.
CONCLUSIONS: TT is an emerging, patient-centered outcome that reflects patients’ burden and quality of life. As TT does not capture clinical benefit, it should be interpreted alongside available evidence on treatment effectiveness. Differences observed between treatment modalities across several cancers highlight the importance of considering time spent in healthcare when evaluating cancer treatments and supporting clinical decision-making.
METHODS: This retrospective registry-based cohort study included secondary data of adult patients treated for breast (n=9,071), lung (n=2,380), urothelial (n=725), kidney cancer (n=1,111), or melanoma (n=3,667) during 2018-2024 in the Helsinki and Uusimaa region, covering 1.8 million inhabitants. Treatment modality was defined hierarchically based on treatments received during the first follow-up year. Immune-oncological (IO) therapies were considered first, then tyrosine-kinase inhibitors (TKI), chemotherapies (CT) in general, and lastly resection of primary tumor (no systemic treatment). TT was assessed via negative binomial regression and estimated marginal means while adjusting for sex, age and receipt of radiotherapy.
RESULTS: Overall first year TT was 39 days. Across cancer types, patients receiving IO therapy spent 24% more days in healthcare contact than those receiving chemotherapy, while TKI therapy and resection without systemic treatment were associated with 15% and 46% fewer days, respectively. TT varied by cancer type with lung cancer associated with 10% more days in healthcare contact than breast cancer, while melanoma, kidney, and urothelial cancers were associated with 46%, 10%, and 7% fewer days, respectively. Highest TT was observed among patients with lung cancer receiving IO therapy with 97 days in the first year (on average 2 days per week) while the lowest was observed among patients with resected melanoma without systemic treatment at 15 days.
CONCLUSIONS: TT is an emerging, patient-centered outcome that reflects patients’ burden and quality of life. As TT does not capture clinical benefit, it should be interpreted alongside available evidence on treatment effectiveness. Differences observed between treatment modalities across several cancers highlight the importance of considering time spent in healthcare when evaluating cancer treatments and supporting clinical decision-making.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR180
Topic
Clinical Outcomes, Epidemiology & Public Health, Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology