International Journal of Technology Assessment in Health Care



William K. Evansa1, Michael C. Wolfsona2, William M. Flanagana3, Janey Shina4, John Goffina5, Anthony B. Millera6, Keiko Asakawaa7, Craig Earlea8, Nicole Mittmanna9, Lee Fairclougha10, Jillian Oderkirka11, Philippe Finèsa11, Stephen Gribblea11, Jeffrey Hocha12, Chantal Hicksa13, D. Walter R. Omaribaa13 and Edward Nga13

a1 Juravinski Cancer Centre at Hamilton Health Sciences and McMaster University

a2 Population Health Modeling/Populomics, University of Ottawa

a3 Health Analysis and Modeling Divisions, Statistics Canada

a4 Canadian Partnership Against Cancer

a5 Juravinski Cancer Centre at Hamilton Health Sciences and McMaster University

a6 Dalla Lana School of Public Health, University of Toronto

a7 Health Analysis and Modeling Division, Statistics Canada

a8 Institute for Clinical Evaluative Sciences and University of Toronto

a9 Centre for Health Outcomes and Pharmacoeconomic Evaluation, Sunnybrook Health Sciences Centre and University of Toronto

a10 Canadian Partnership Against Cancer

a11 Health Analysis and Modeling Divisions, Statistics Canada

a12 Pharmacoeconomics Research Unit, Cancer Care Ontario; The Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Canada; Canadian Centre for Applied Research in Cancer Control (ARCC), Canada; Institute of Health Policy, Management and Evaluation, University of Toronto

a13 Health Analysis and Modeling Divisions, Statistics Canada


Objectives: The aim of this study was to develop a decision support tool to assess the potential benefits and costs of new healthcare interventions.

Methods: The Canadian Partnership Against Cancer (CPAC) commissioned the development of a Cancer Risk Management Model (CRMM)—a computer microsimulation model that simulates individual lives one at a time, from birth to death, taking account of Canadian demographic and labor force characteristics, risk factor exposures, and health histories. Information from all the simulated lives is combined to produce aggregate measures of health outcomes for the population or for particular subpopulations.

Results: The CRMM can project the population health and economic impacts of cancer control programs in Canada and the impacts of major risk factors, cancer prevention, and screening programs and new cancer treatments on population health and costs to the healthcare system. It estimates both the direct costs of medical care, as well as lost earnings and impacts on tax revenues. The lung and colorectal modules are available through the CPAC Web site ( to registered users where structured scenarios can be explored for their projected impacts. Advanced users will be able to specify new scenarios or change existing modules by varying input parameters or by accessing open source code. Model development is now being extended to cervical and breast cancers.


  • Cancer;
  • Simulation model;
  • Policy tool