Provincial Coverage of the PSA Test

Excerpt from the 2008 Ontario Budget Promoting Health and Preventing Illness The government continues to focus on active and healthy living, health promotion and illness prevention. Over the long term, these investments should help manage health care costs. With this Budget, the government is planning to invest: $154 million over the next three years to build on the Province’s cancer screening program to increase early detection and treatment of breast, cervical and colorectal cancers. This will also cover the cost of the Prostate-Specific Antigen (PSA) test used to diagnose and monitor treatment of prostate cancer, and extend the human papillomavirus (HPV) vaccination program. Click here to download Section E of the 2008 Ontario Budget entitled “A Healthier Ontario: Strengthening Health Care for the Future.”

The 2008 Ontario budget, unveiled on March 25, includes a promise to cover the cost of the prostate-specific antigen (PSA) test as a screening tool in the early diagnosis of prostate cancer.

When this budgetary policy is implemented, Ontario will be the tenth of Canada’s thirteen provinces and territories whose health insurance program covers PSA testing as a screening tool, joining Newfoundland, Prince Edward Island, Nova Scotia, New Brunswick, Saskatchewan, Manitoba, Nunavut, the Northwest Territories, and the Yukon.

The Ontario government made its promise to fund PSA test coverage as part of a $154 million package to be used over the next 3 years for the early detection of cancer. Details such as how old a man must be before his PSA testing is covered, the frequency of testing allowed by the coverage, or when Ontario’s new testing policy will be implement are not currently available. However, Health Minister George Smitherman is scheduled to make an announcement about PSA test coverage this fall.

There is also a strong rumour that coverage will start on January 2009. In fact, The Sudbury Star reported in April that this was the program’s start date and quoted Smitherman as saying that “he's been telling people since last month's budget that the province will start paying for the PSA tests next January.”

CPCN applauds the Ontario government for taking this positive step, and our members have been active in promoting this change in Ontario’s policy. (See the article on CPCN delegates meeting with The Honourable George Smitherman in 2007.) We will continue to encourage British Columbia, Alberta, and Quebec to join with the rest of Canada in covering PSA testing as a means of diagnosing prostate cancer early, when it can be cured. (Click here to read our position on early detection.)

Unfortunately, the news from British Columbia is not as positive. You may recall that last year Laurence Armstrong, a lawyer from Victoria, brought a case of sexual discrimination against the BC Ministry of Health because it did not cover the cost of a man’s annual PSA test to screen for prostate cancer while it did cover a woman’s annual mammogram to screen for breast cancer. (Click here for the original CPCN story.)

In January 2008, the BC Human Rights Tribunal rejected Armstrong’s claim. The decision to fund cancer screening tests for women but not for men was based “on the questionable scientific support for the efficacy of PSA screening as a population-wide screening device,” said tribunal spokesperson Kurt Neuenfeldt, not “on the fact that Mr. Armstrong is male.” So it did not constitute a case of sexual discrimination. (See the CBC report on this ruling.)

Currently, BC health insurance does not cover the cost of PSA testing when it is used as a diagnostic screening tool, but it does cover PSA tests used for monitoring established metastatic disease, for the detection of early recurrence, and for the evaluation of men with symptoms.