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Prostate Cancer Surgery Across Canada

August 21, 2014—Thousands of Canadian men are diagnosed with prostate cancer each year. In fact, an estimated 23,600 were diagnosed in 2013 alone. The Delivery of Radical Prostatectomy to Treat Men With Prostate Cancer, a study by the Canadian Institute for Health Information (CIHI), examined radical prostatectomies (RPs)—the most common surgical intervention for prostate cancer in Canada—that were done between 2006–2007 and 2012–2013.

A number of surgical and non-surgical treatment options are available for prostate cancer, and the chosen course is influenced by a range of factors, including the diagnosis and the patient’s preference. RP is performed using either an open approach or a laparoscopic approach; robotic devices are available at certain hospitals to help with laparoscopic procedures.

The study observed that surgical approaches to prostate cancer varied greatly with a hospital’s location. In Canada, a man receiving surgery in one province is almost certain to have an open procedure, whereas a man receiving surgery in another province is as certain to have a laparoscopic procedure.

Use of Laparoscopic Radical Prostatectomy in Canada, 2012–2013
N.L. <1% Ont. 26%
P.E.I. <1% Man. 1.6%
N.S. <1% Sask. 87%
N.B. 31% Alta. 63%
Que. 35% B.C. 15%

Just as surgical approaches varied from province to province, selected surgical outcomes differed between approaches. For example, men who underwent laparoscopic procedures had a shorter length of stay in hospital than men undergoing open surgery; however, men receiving open RPs spent less time in the operating room. Patient readmission rates were similar between surgical approaches, with rates of 3.8% for open and non-robotic laparoscopic RPs and 3.9% for robotic laparoscopic RPs.

This analysis is part of a larger, more comprehensive study of treatments for men with prostate cancer that CIHI is undertaking. It does not provide the full range of evidence relative to costs and outcomes for RPs in Canada, as this information is currently not available.