Project Overview (live on website)

Early detection of prostate cancer uses methods that are controversial and lead to uncertainty in care with considerable early overdiagnosis and overtreatment in healthy individuals and in those with inactive disease. For example, estimates show that up to 46% of prostate cancer patients undergo unnecessary surgical treatment. Surgical treatments place a high burden on patients because over one-thirds (35%) will experience surgical complications, with permanent reduction in functional capacity and serious compromise to quality of life. This health burden—one that is disproportionately higher in lower socioeconomic groups—also comes at a high economic cost to individuals and to the healthcare system.

One of the main reasons for overtreatment of prostate cancer is the lack of a test that can correctly classify men as high-risk or low-risk. Too many men are receiving unnecessary biopsies and treatments for prostate cancer because physicians currently use a blood test based on the quantity of a special protein that is made by abnormal prostate cells, called prostate-specific antigen (PSA). Since PSA levels fluctuate naturally over a person’s lifetime and can rise due to ageing, the test is not specific and falsely detects prostate cancer. Thus, there is an unmet clinical need to detect high-risk cancer patients and provide medical information to improve decision-making before ordering a prostate biopsy.

Recently, we have developed a test using a sugar found on aggressive cancer cells that acts as a biomarker to detect high-risk cancer in patients and support biopsy decision-making. It adds important clinical information to the current PSA-based blood test and will address a critical issue of overdiagnosis in prostate cancer. Our new test measures a specific carbohydrate (polysialic acid) found on structures released by prostate cells, and performs well in the early detection of high-risk patients. For this test to be taken up in Canada to improve patient care, it needs to be evaluated for its potential value for money for the healthcare payer. This is important for the efficient performance and sustainability of the healthcare system.

We will address a critical gap in test development early on to avoid the pitfall of creating an economically non-feasible test. This project is the first analysis of the cost-effectiveness of a new sugar-based prostate cancer diagnostic tool. It will tell us whether the maximum possible gains from the new test versus status quo (or other new technologies) are worth their costs, and in which subgroups of patients we see the most positive net benefit. In funding this work, GlycoNet is helping us achieve its vision of delivering solutions to an important health issue in Canadian men and thereby improve their quality of life through glycomics.

We bring together biological, clinical, epidemiological and economic expertise to map the patient care process, collect data on costs and outcomes of prostate cancer detection methods, and build a mathematical model to assess their cost-effectiveness. The output of this project could contribute to improved patient care and better decision-making of patients, guideline developers and health ministers.