The landscape of prostate cancer research in Canada.

394 Background: Prostate cancer (PCa) is the most prevalent malignancy in Canadian men; in 2023, an estimated 24,700 men will be diagnosed while ~4,700 will die of their disease. Lifetime risk of developing PCa is approximately 1-in-8 and approximately 3% of all deaths of Canadian men are caused by the disease. While Canada has a robust, modern health research landscape, with major academic centres located in all provinces and territories, the investment in academic PCa research – and the impact of that investment – has not been systematically quantified. An improved understanding of this landscape is necessary to ensure research funding remains efficient, impactful, and equitable. As such, we evaluated the size, scope, and impact of the investment in academic PCa research in Canada. Methods: We extracted funding records from the Canadian Research Information System (CRIS), the United States Congressionally Directed Medical Research Program database and the United States National Institutes of Health RePORT database for the National Cancer Institute, using keywords ‘prostate’ OR ‘prostatic’ AND ‘cancer’ OR ‘carcinoma’ for 1999-2021. US-sourced records were included when the principal investigator (PI) was based at a Canadian institution at the time the award was granted. Records were validated using data from the Canadian Cancer Research Alliance (CCRA). Intramural and industry-derived funding was unavailable and thus excluded from the analysis. Results: We identified 1,748 unique funding events (FEs) from 33 sources. These FEs involved 1,561 investigators and had an inflation-adjusted value of $682,113,116. The top three funders of PCa research were the Canadian Institutes of Health Research, Movember Canada, and the Canadian Cancer Society. Basic and translational research received ~83% of all funding while psychosocial, health economics, and epidemiology research received only ~7.2%. Strikingly, we found that 30.5% of all funding was held by 1% of investigators. We identified 6,671 dyads ( ie. pairs of collaborating investigators); 85% collaborated only once, while 15% collaborated at least twice (range: 2-19). Female investigators participated in significantly fewer collaborations than males (P: 3.28 x 10-3) and were less likely than expected to serve as PI (P: 8.87 x 10-8). FEs with ≥ one female PI had a significantly lower value than those with only male PIs (P: 1.34 x 10-6) and FEs with only female PIs had a significantly value than those with only male PIs (P: 7.32 x 10-4). Conclusions: While Canadian PCa research has been highly funded over the past 25 years, there remain substantial funding disparities across scientific disciplines, geographic regions, and, in particular, gender. There is also substantial ‘wealth inequality’; a small minority of investigators receive most of the funding. We are currently assessing stakeholder attitudes toward these disparities, to help inform the next phase of PCa research funding in Canada.

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