This indicator examines the breakdown of disease site-specific cancer research funding estimates for prostate, breast, colorectal and lung cancers, using information on research spending reported to the Canadian Cancer Research Alliance (CCRA) in 2012. This information compares the allocations of funding to the relative burden of these cancers in terms of incidence (2010) and mortality (2011). This section also presents data from the five largest prostate cancer research funders in Canada and examines the distribution of their investment into various areas of prostate cancer research in 2005 and 2012. The provincial per capita investment in prostate cancer research for 2005 and 2012 are also examined for all provinces.
Adequate support of research directed to specific cancers helps advance the state of the science and accelerate translating discoveries for the benefit of patients. Priorities for prostate cancer research include: developing specific diagnostic tests; identifying novel biomarkers and imaging technologies that can distinguish indolent from aggressive disease; reducing treatment-related toxicities; and developing guidelines aimed at identifying men with prostate cancer who might be considered eligible for active surveillance or watchful waiting (i.e., rather than immediate treatment).
The chapter also looks at pooled data from the five largest research funders in Canada and examines the distribution of their investment against the Common Scientific Outline (CSO) in 2005 and 2012. The CSO includes seven categories intended to capture a wide array of research areas (see Table 5.3).1
What are the results?
In 2012, $541.6M was invested in cancer research in Canada; of that, $286.1M was invested in cancer site-specific research, with $37.8M (13.2%) invested in prostate cancer. This was proportionally less than the site-specific research investment for breast cancer (26.5%), but higher than the investments for research into lung cancer (6.7%) and colorectal cancer (6.7%) (Figure 6.7).
Prostate cancer accounted for 5.3% of cancer deaths in Canada that year and received 13.2% of site-specific research dollars in 2012 (Figure 6.7).
The top five prostate cancer research funding agencies in 2012 represented 72.5% of total research into prostate cancer in 2012 (Table 5.1). In both 2005 and 2012, the Canadian Institutes of Health Research (CIHR) had the highest level of investment, representing 17.7% and 28.7% of the overall prostate cancer research investments, respectively (Tables 5.1 and 5.2). Prostate Cancer Canada was the second largest investor in 2012; this represents more than a seven-fold increase from 2005. While the Canada Foundation for Innovation (CFI) was the second largest funder in 2005, it was the eighth largest investor in 2012 (Table 5.2; data not shown). The Ontario Institute for Cancer Research (OICR) was the sixth largest funder in 2005 and the third largest investor in 2012, due to its major investment in the Canadian Prostate Cancer Genome Network (CPC-GENE) (data not shown; Table 5.1). The CPC-GENE project aims to decode the prostate cancer genome and then develop personalized cancer therapies for patients, which may decrease overtreatment. Prostate Cancer Canada is also a major investor in the CPC-GENE project.
Figure 6.8 shows the changing pattern of cancer research investment distribution by area of science in 2005 and 2012 for the top five prostate cancer research funding agencies. While the distribution of investment into areas of prostate cancer research changed over those seven years, the investment amount increased across all CSO-defined areas of research except for Cancer control, survivorship and outcomes research. Funding for this area decreased from approximately $884K (7.2%) in 2005 to $630K (2.3%) in 2012 (Figure 6.8).
The major investments during the seven-year period were in research related to Early detection, diagnosis and prognosis and Treatment; this accounted for 65.1% of the overall funding from the top five funders in 2012 (Figure 6.8).
The highest percentage change in the distribution of investment among the top five funders from 2005 to 2012 was for research into Early detection, diagnosis and prognosis; funding went from 19.3% in 2005 to 35.8% in 2012. The investment in research looking at Etiology also increased by 8.2% from 2005 to 2012 (Figure 6.8).
The per capita investment in prostate cancer research in 2005 and 2012 was also examined for the Canadian male population for each province. In 2012, the largest investment was in British Columbia ($4.18 per man); the lowest was in Saskatchewan at $0.09 per man (Figure 6.9).
Per capita investments in Alberta, Manitoba, Ontario, Quebec, New Brunswick, Nova Scotia, Prince Edward Island and Newfoundland and Labrador were higher in 2012 than in 2005; per capita investments in British Columbia and Saskatchewan were lower in 2012 than in 2005 (Figure 6.9).
What do the results mean?
Assessing research funding relative to disease burden helps cancer research funders identify important areas and gaps where additional research funding may be needed.
The National Cancer Research Institute (NCRI) in the United Kingdom has reported that the highest levels of funding were allocated to breast cancer research compared to spending for research involving other cancer sites. In 2011, the United Kingdom (unlike Canada) provided less funding (7.7% of site-specific funding) for prostate cancer research than it did for research into colorectal cancer.2
The National Cancer Institute (NCI) in the United States allocated $255.6 million to prostate cancer research in 2013. Using the CSO codes, the most of the NCI-funded research for prostate cancer was invested in Biology (24%), followed by Treatment (23%) and Early detection, diagnosis and prognosis (18%).3
In Canada, we have seen a large shift in the distribution of funding to Early detection, diagnosis and prognosis research. Some differences among the top five funders emerged—specifically the Ontario Institute for Cancer Research (OICR) and Prostate Cancer Canada (PCC). These research agencies invested a significant proportion of their funding into Early detection, diagnosis and prognosis. This likely reflects the inauguration of a joint project between OICR and PCC’s Canadian Prostate Cancer Genome Network (CPC-GENE). As explained earlier, the CPC-GENE project aims to decode the prostate cancer genome, in order to develop personalized cancer therapies for patients and to decrease overtreatment.4 The increased investment into Etiology also reflects the large investment into the CPC-GENE project.
Another project that likely contributed to the investment shift in this area is the Medical Imaging Trial Network of Canada (MITNEC), a project funded by the Canadian Institutes of Health Research (CIHR). This network facilitates multi-centre clinical trials that will ultimately lead to approval of the new radio-pharmaceutical products by Health Canada and their subsequent uptake into clinical practice.5 Although a number of provinces are involved in MITNEC, the nominated principal investigator is located in Quebec.5
Projects are under way that affect Quebec’s large per capita investment in prostate cancer research. One is the Quebec Research Program for Prostate Cancer Prevention administered by the Cancer Research Society; funding comes from both the Cancer Research Society and the Quebec government.6
A considerable number of Canadian men (an estimated 176,361 in 2009) are living with or beyond prostate cancer.7 Yet there was a decrease in investment in Cancer control, survivorship and outcomes research 2012. It is important to determine what types of survivorship research would most likely address the unmet needs of prostate cancer.
International Cancer Research Partnership. Common Scientific Outline [Internet]. International Cancer Research Partnership; 2012 [updated 2014 Dec 2; cited 2014 September 4]. Available from: https://www.icrpartnership.org/CSO.cfm
National Cancer Research Institute. Cancer research spend in the UK 2002-2011: An overview of the research funded by NCRI Partners. Institute NCR; 2013. 54 p.
Ontario Institute for Cancer Research. International Cancer Genome Consortium announces $20 million Canadian research project to decode the prostate cancer genome [Internet]. Toronto (ON): Ontario Institute for Cancer Research; 2011 [updated 2011 Feb 15; cited 2011]. Available from: https://oicr.on.ca/files/public/icgc_nr_february152011.pdf
Canadian Institutes of Health Research. Clinical translation: The Medical Imaging Trial Network of Canada (MITNEC) [Internet]. Ottawa (ON): Canadian Institutes of Health Research; 2012 [updated 2012 Jul 17; cited 2014 Sep 19]. Available from: http://www.cihr-irsc.gc.ca/e/45577.html#a5
Data come from the Canadian Cancer Research Survey (CCRS), which is carried out by the Canadian Cancer Research Alliance (CCRA). In 2012, the survey captured funding information from 42 organizations including governmental and voluntary sectors across Canada.
The CCRS captures research investments by federal agencies and programs, provincial government organizations and voluntary organizations; however, it does not capture investments made by hospital foundations (e.g., the BC Cancer Foundation, the Princess Margaret Hospital Foundation); organizations outside the country that fund Canada-based research (e.g., the National Cancer Institute in the United States); or industry-sponsored research and development. The survey captures at least 65% of the total estimated investment in cancer research.
For this analysis, investment in research that was relevant to all cancer sites or not site-specific was excluded. That is, only projects or grants in which the prostate cancer share of the total was greater than 1% were included.
Research areas are based on Common Scientific Outline (CSO) codes. Where more than one CSO code was assigned to a research project, the investment was distributed equally among the codes.
Burden of disease (as defined by incidence and mortality) is just one way to assess research investment; many other indicators are used to assess health burden. For the purpose of this report, however, only incidence and mortality were considered.
Project equivalents (Figure 6.9) refers to the sum of projects weighted by their cancer relevance. For example, in British Columbia in 2005, there were 53 projects in total. When their cancer relevance was accounted for, the number of projects decreased slightly to 47.7.
Cancer research investment for the four most common cancers
Definition: The percentage distribution of cancer research investment across the four most common cancers (breast, prostate, lung, colorectal) in 2012. Within each disease site, distributions are shown alongside the percentage of new cancer cases in 2010 and cancer deaths in 2011. An ‘other’ category is also included to show the remaining distribution of cancer research investment.
Investment: Amount of site-specific research investment (in dollars) for breast, prostate, lung, colorectal, or other cancers;
New cases: Number of site-specific cases for breast, prostate, lung, colorectal, or other cancers;
Deaths: Number of site-specific deaths from breast, prostate, lung, colorectal, or other cancers.
Investment: Total amount of site-specific cancer research investment (in dollars);
New cases: Total number of site-specific cases;
Deaths: Total number of site-specific deaths.
Investment: Canadian Cancer Research Alliance, Canadian Cancer Research Survey;
New cases: Statistics Canada (CANSIM Table 103-0553), Canadian Cancer Registry;
Deaths: Statistics Canada (CANSIM Table 102-0552), Vital Statistics Death Database.
Measurement timeframe: 2012 (cancer research investment), 2010 (new cancer cases), 2011 (cancer deaths)
Stratification variables: disease site (breast, prostate, lung, colorectal, other)
General notes: N/A
Prostate cancer research investment across areas of research for the top five funders
Definition: The percentage of investment in prostate cancer research by the top five funders* across the following five areas of research:
Biology; Etiology; Prevention; Early Detection, Diagnosis & Prognosis; Treatment; Cancer Control, Survivorship & Outcomes; and Scientific Model Systems.
Numerator: Amount of prostate cancer research investment contributed by the top five funders (in dollars) for a given area of research
Denominator: Total amount of prostate cancer research investment contributed by the top five funders (in dollars)
Data source: Canadian Cancer Research Alliance, Canadian Cancer Research Survey
Measurement timeframe: 2005, 2012
Stratification variables: Year (2005 vs. 2012)
Provinces submitting data: All
Research areas are based on Common Scientific Outline Codes.
*In 2012, the top five funders were the Canadian Institutes of Health Research, Prostate Cancer Canada, Ontario Institute for Cancer Research, The Terry Fox Foundation, and Canadian Cancer Society. In 2010, the top five funders were the Canadian Institutes of Health Research, Canada Foundation for Innovation, Canadian Cancer Society, Terry Fox Foundation, and Prostate Cancer Canada.
Per capita investment (male population) in prostate cancer research
Definition: The amount of per capita investment (in Canadian dollars) for prostate cancer research in each province
Numerator: Total amount of prostate investment (in Canadian dollars) from a given province in a given year
Denominator: The total male population (all ages) from a given province in a given year
Data source: Canadian Cancer Research Alliance, Canadian Cancer Research Survey
Measurement timeframe: 2005, 2012
Stratification variables: Province, year (2005 vs. 2012)
Comparison of the relative burden of disease to the relative investment in research by disease site: Distribution of cancer research investment (2013), new cancer cases (2012) and cancer deaths (2011), by disease site, Canada