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CMAJ • April 4, 2000; 162 (7)
© 2000 Canadian Medical Association or its licensors

Research
Recherche

The economic burden of prostate cancer in Canada: forecasts from the Montreal Prostate Cancer Model

Steven A. Grover, Louis Coupal, Hanna Zowall, Raghu Rajan, John Trachtenberg, Mostafa Elhilali, Michael Chetner and Larry Goldenberg

From the Centre for the Analysis of Cost-Effective Care and the Divisions of General Internal Medicine and Clinical Epidemiology, Montreal General Hospital, and the Departments of Medicine and of Epidemiology and Biostatistics, McGill University, Montreal, Que., the Department of Surgery, University of Toronto, Toronto, Ont., and the Department of Surgery, University of British Columbia, Vancouver, BC

Background: We developed an economic model of prostate cancer management from diagnosis until death. We have used the Montreal Prostate Cancer Model to estimate the total economic burden of the disease in a cohort of Canadian men.

Methods: Using this Markov state-transition simulation model, we estimated the probability of prostate cancer, annual prostate cancer progression rates and associated direct medical costs according to patient age, tumour stage and grade, and treatment modalities in a 1997 cohort of Canadian men. The estimated lifetime costs of prostate cancer included the costs of clinical staging, initial treatments and complications, follow-up cancer therapies, routine outpatient care, and palliative care following metastatic disease.

Results: The clinical burden of prostate cancer forecasted using the model was similar to the projections of the National Cancer Institute. In the 1997 cohort of 5.8 million Canadian men between 40 and 80 years old, prostate cancer would be diagnosed in an estimated 701 491 men (12.1%) over their lifetime. Direct medical costs would total $9.76 billion, or $3.89 billion when discounted 5% annually.

Interpretation: The Montreal Prostate Cancer Model indicates that the economic burden of prostate cancer to Canada's health care system will be substantial. Further analyses are needed to identify the most efficient means of treating this disease.




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