title: The economic burden of prostate cancer in Canada: forecasts from the Montreal Prostate Cancer Model.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Centre for the Analysis of Cost-Effective Care, Montreal General Hospital, Que.
authors.forename: S A
authors.initials: SA
authors.lastname: Grover
authors.forename: L
authors.initials: L
authors.lastname: Coupal
authors.forename: H
authors.initials: H
authors.lastname: Zowall
authors.forename: R
authors.initials: R
authors.lastname: Rajan
authors.forename: J
authors.initials: J
authors.lastname: Trachtenberg
authors.forename: M
authors.initials: M
authors.lastname: Elhilali
authors.forename: M
authors.initials: M
authors.lastname: Chetner
authors.forename: L
authors.initials: L
authors.lastname: Goldenberg
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D015331:Cohort Studies; D017281:Cost of Illness; D005544:Forecasting; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D011471:Prostatic Neoplasms / Q000191:economics* / Q000628:therapy