Table 1:
Data inputs for the microsimulation models
| Variable | Cancer site | |||||||
|---|---|---|---|---|---|---|---|---|
| Breast | GI | GU | Gyne | HN | HPB | Lung | Prostate | |
| No. of patients awaiting cancer surgery on day 1 of pandemic* | 922 | 390 | 1619 | 444 | 288 | 158 | 263 | 555 |
| Daily no. of new patients awaiting cancer surgery† | 36 | 18 | 36 | 16 | 11 | 6 | 10 | 7 |
| Time on wait-list for day 1 patients, d‡ | 55 | 63 | 55 | 37 | 62 | 71 | 20 | 70 |
| Operating room capacity during pandemic§ | ||||||||
| Month 1 | 60 | 60 | 60 | 60 | 60 | 60 | 60 | 60 |
| Month 2 | 70 | 70 | 70 | 70 | 70 | 70 | 70 | 70 |
| Months 3–6 | 85 | 85 | 85 | 85 | 85 | 85 | 85 | 85 |
| Risk of progression¶ | Low | Mod. | Mod. | Mod. | High | High | Mod. | Low |
| Daily HR applied for risk of death associated with increase in wait time | 1.0030 | 1.0056 | 1.0056 | 1.0056 | 1.0056 | 1.0056 | 1.0056 | 1.0030 |
| WM-1 | 1.0027 | 1.0052 | 1.0052 | 1.0052 | 1.0052 | 1.0052 | 1.0052 | 1.0027 |
| WM-2 | 1.0032 | 1.0060 | 1.0060 | 1.0060 | 1.0060 | 1.0060 | 1.0060 | 1.0032 |
| WM-3 | 1.0030 | 1.0056 | 1.0056 | 1.0056 | 1.0105 | 1.0105 | 1.0056 | 1.0030 |
Note: GI = gastrointestinal, GU = genitourinary, Gyne = gynecological, HN = head and neck, HPB = hepatobiliary, HR = hazard ratio, Mod. = moderate; OH-CCO = Ontario Health – Cancer Care Ontario, SE = standard error, WM = wait time mortality, WTIS = Wait Time Information System.
Number of patients on day 1 represents the estimate for patients already on the wait-list for cancer surgery as of the first day of the pandemic, as derived from OH-CCO WTIS data from 2019.
Daily number of new patients awaiting cancer surgery estimated from the total volume of patients waiting for cancer surgery over a 3-month time period in 2019, derived from OH-CCO WTIS data.
Time on waitlist for patients on wait-list as of the first day of the pandemic initially estimated from the mean, cancer-specific wait time in July 2019, with further calibration to target total model wait time to real-world wait times in the base-case analysis. This estimate represents the wait time that patients waiting for cancer surgery had already waited as of the start of the model.
The provincial operating room capacity within the first 6 months of the initial pandemic declaration was derived from OH-CCO data. This was characterized as the operating room capacity within the first month (month 1), operating room capacity within the second month (month 2) and operating capacity in the third through sixth month (months 3–6).
A cancer’s risk of progression to death is based upon its historical 5-year survival estimates, classified as low risk of progression (5-yr survival > 90%), moderate risk of progression (5-yr survival 50%–90%) or high risk of progression (5-yr survival < 50%).9 To account for the uncertainty in the daily HR for risk of death applied with increases in wait time, scenario analyses were conducted using alternative HRs to depict lower risk of death owing to longer wait times for all cancers (WM-1), higher risk of death owing to longer wait times for all cancers (WM-2), and higher risk of death owing to longer wait times for cancers classified at a high risk of progression (WM-3).