Cancer Science and Therapy

Significant advances have been made in the field of urological cancers, including new health technologies for localized cancers and many innovative drugs for advanced cancers. These novel treatment options are generally more expensive than existing treatments which limits their implementation in current clinical practice. Particularly, several new tests have demonstrated clinical utility and benefits in the screening, diagnosis or treatment phase of prostate cancer. Unfortunately, none of these tests are currently used routinely in clinical practice in Canada or other countries. One of the reasons is the lack of evidence regarding their cost-effectiveness. Recently, the Canadian Task Force on Preventive Healthcare and other similar entities from other countries, recommended against PSA screening in all men. We believe that applying this recommendation regardless of risk- and age-stratification to all men is an extreme strategy, especially considering the lack of economic evidence. An alternative needs to be found in a more proficient way to perform prostate cancer screening, diagnosis and treatment. Identifying the new prognosis/risk assessment tests or interventions which are cost-effective could be a first step in achieving this goal. Better prostate cancer risk assessment tools will assist the decisionmaking process, which would finally lead to the best therapeutic options being offered to individual patients, improve overall patient

care, and reduce healthcare expenditure. This presentation presents results of several studies aimed to determine the best solutions for urological cancer screening, diagnosis and treatment for improving healthcare delivery to patients, increase access to these new advances, while uncovering better ways to optimize health services and cost allocation.