Equitable access to prostate cancer testing and treatment in Canada

Why it matters

The prostate-specific antigen (PSA) test is the first step in the prostate cancer diagnostic pathway and the best method currently available to help find prostate cancer early. It’s a blood test that can detect elevated levels of PSA, which means there may be cancer or another health concern with the prostate that requires further testing. Prostate cancer often has few to no symptoms in its early stages, meaning early detection is critical.

People in Canada should have equitable access to the PSA test for early detection of prostate cancer without having to pay out of pocket when they have a referral from a healthcare provider, regardless of where they live in Canada. Efforts must be made to ensure fair and timely access to early detection tools without placing costs on people receiving care. This is especially important for communities that are underserved and people who are at high risk of prostate cancer, who often experience disparities like diagnosis at earlier ages and poorer outcomes.

What we are advocating for right now

The Canadian Cancer Society (CCS) is urging the governments of British Columbia and Ontario to cover 100% of the cost of the PSA test through their provincial health insurance plans for asymptomatic men and people with prostates with a healthcare provider referral. There should be no cost barrier to anyone who would like to test early for prostate cancer before any signs or symptoms.

Right now, the cost of PSA testing for early detection with a healthcare provider referral is covered in 8 provinces and all 3 territories. Only British Columbia and Ontario do not cover the cost of the PSA test as an early detection tool for those who do not have signs or symptoms of prostate cancer when referred by a healthcare provider. Cost is a barrier that may prevent or discourage people from getting tested and delay early detection.

As with many cancers, drugs play a vital role in treating prostate cancer. These medications can help slow the cancer’s growth, manage symptoms and improve quality of life, especially in advanced or treatment-resistant cases. Yet in Canada, a patchwork of drug coverage creates inequities and restricts access to treatment for many Canadians. Dealing with a cancer diagnosis is difficult enough. People with cancer should not have to face additional challenges and anxiety trying to access their prescribed treatment. To ensure all Canadians benefit from these advances, we urge all governments to guarantee timely, affordable and equitable access to prostate cancer medications, no matter where patients live or how their treatment is delivered.

The Canadian Cancer Society further calls on provinces and territories to do the following:

Ensure that patients have access to easy-to-understand information on prostate cancer risk and the benefits and limitations of PSA testing. Resources should be tailored for different groups and available in various languages and formats.
Give healthcare providers effective tools and resources for understanding and discussing prostate cancer risk, PSA testing and the diagnostic pathway with patients.
Evaluate and adopt innovative and effective tools and methods for early prostate cancer detection, such as the PSA test, ensuring they are accessible at no cost to patients, free from unnecessary regulatory barriers, and integrated safely into the diagnostic pathway.
Co-design with communities to create strategies to improve prostate cancer awareness and experiences with prostate cancer early detection.

The Canadian Cancer Society calls on the federal government to do the following:

The federal government should clearly define low, average, and high-risk groups for prostate cancer, involve underserved and high-risk communities in developing culturally safe guidelines, and recommend accessible tools to assess individual risk.

Updated clinical guidelines should clarify the role of PSA testing, provide specific protocols for high-risk individuals, support informed decision-making for patients and providers, streamline regulatory processes for innovative diagnostics, and ensure effective dissemination of guidelines to healthcare professionals and eligible individuals. Evaluate and adopt innovative and effective tools and methods for early prostate cancer detection, such as the PSA test, ensuring they are accessible at no cost to patients, free from unnecessary regulatory barriers, and integrated safely into the diagnostic pathway.

The Canadian Cancer Society calls on governments, funders and those who collect and work with data to do the following:

Identify where prostate cancer data can be improved and collect data to fill gaps, including race-based data collection across the cancer control continuum. Important opportunities are found in the pan-Canadian cancer data strategy and pan-Canadian Health Data Charter.
Invest in research that aims to:

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