CMAJ OPEN

Cancer is the leading cause of premature death andthe fourth leading cause of hospital admission inCanada.1 The most recent estimate of the total cost of cancer care in Canada is $14.2 billion in 1998.2 Cancer is the third most costly disease category, after cardiovascular and musculoskeletal diseases.2 The first year after cancer diagnosis is a period of particu-larly high costs and intensive treatment.3,4 One study in the United States found that first-year costs were highest for brain, pancreatic, esophageal and gastric cancers, and lowest for melanoma of the skin.3 To our knowledge, no comprehensive studies of pre- and postdiagnosis costs in Canada have been published. Few studies in any country have examined the costs of cancer treatment for patients under the age of 65 years.5,6 Our objective was to estimate the pre- and postdiagnosis costs for patients who received diagnoses for the 21 most common cancers in Ontario between 1997 and 2007, and t