The incidence of prostate cancer is increasing, as is the number of diagnostic and therapeutic interventions to manage this disease. Dr. Steven Grover and colleagues have developed the Montreal Prostate Cancer Model to follow a hypothetical cohort of men to estimate the probability of prostate cancer and the annual progression of the disease according to patient age, tumour stage and grade, and initial treatment.
The model's 10-year disease-specific survival estimates following prostatectomy for tumour grades 1, 2 and 3 were 96%, 92% and 84% respectively. In comparison, data from the Surveillance, Epidemiology and End Results (SEER) Program, based on more than 59 000 cases of localized prostate cancer, show rates of 98%, 91% and 76%, respectively.
Given the comparable results, the authors conclude that the Montreal Prostate Cancer Model can be used to guide decision-making for the management of prostate cancer and to forecast clinical outcomes for men with prostate cancer or who are at risk for the disease.
In an accompanying article the authors use the model to estimate the economic burden of prostate cancer. In a 1997 cohort of 5.8 million Canadian men aged 40 to 80 years prostate cancer would eventually be diagnosed in an estimated 701 491 men (12.1%) over their lifetime, and the direct medical costs would total $9.76 billion.
In an related commentary, Jaime Caro, Scientific Director of the Caro Institute in Concord, Mass., suggests that society should collectively invest in such disease-simulation models, rendering them public tools, in order to facilitate scientific scrutiny and replication.
The clinical burden of prostate cancer in Canada: forecasts from the Montreal Prostate Cancer Model -- Dr. Steven Grover and colleagues
The economic burden of prostate cancer in Canada: forecasts from the Montreal Prostate Cancer Model -- Dr. Steven Grover and colleagues
Disease-simulation models and health care decisions -- Dr. Jaime Caro
Journal
Canadian Medical Association Journal