A decision analytical modelling study that used the health-augmented macroeconomic model with aim to estimate the global economic cost of 29 cancer types for 204 countries and territories is the first study to account for productivity loss among people with different educational and experience levels. The findings bridge several knowledge gaps. The study team estimated that between 2020 and 2050, cancers will cost the world economy $25.2 trillion in international dollars, which is equivalent to an annual tax of 0.55% on global gross domestic product (GDP) during this period and higher than the GDP of China in 2020 (the world’s largest economy in 2017 international dollars).
The health and economic costs of cancers were distributed unevenly across cancer types, countries, and regions. Investment in cancer mitigation, such as cancer research and development, cost-effectiveness analysis of interventions, and cancer prevention strategies, may yield substantial economic benefits. The findings are published by Simiao Chen, ScD of the Heidelberg Institute of Global Health in Heidelberg, Germany, Dr. Chen Wang of the Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing, China, and colleagues on 23 February 2023 in the JAMA Oncology.
Cancers are a leading cause of death worldwide, causing 10.0 million deaths in 2019. The incidence of cancers and resultant mortality are increasing all over the world. The health burden of cancers is distributed unevenly across countries, with high-income countries facing a greater per-population burden in terms of disability-adjusted life-years than low- and middle-income countries (LMICs). Cancers impose a marked toll on the economy through reduced productivity, unemployment, labour losses, and capital investment reductions. Accordingly, investment in cancer screening, diagnosis, and treatment could yield substantial health and economic benefits, especially in LMICs, which have lower levels of cancer survival compared with high-income countries.
Several previous studies have assessed the economic cost of cancers for a single or a limited set of countries or cancer types. Two studies estimated and projected the macroeconomic cost of all cancers; however, these studies are 10 or more years old, and the estimates should therefore be updated. Furthermore, most previous approaches have not accounted for the dynamics of morbidity and mortality–related changes in the population and the implications of treatment costs for savings (and thus capital accumulation).
The latest decision analytical model that incorporated economic feedback in assessing health outcomes associated with the labour force and investment. A macroeconomic model was used to account for the association of cancer-related mortality and morbidity with labour supply, age-sex-specific differences in education, experience, and labour market participation of those who are affected by cancers, and the diversion of cancer treatment expenses from savings and investments. Data were collected on 25 April 2022.
The authors found that estimated global economic cost of cancers from 2020 to 2050 is substantial, $25.2 trillion in international dollars (at constant 2017 prices), equivalent to an annual tax of 0.55% on global GDP. Five malignancies with the highest economic costs are tracheal, bronchus, and lung cancer (15.4%), colon and rectal cancer (10.9%), breast cancer (7.7%), liver cancer (6.5%), and leukaemia (6.3%). China and the US face the largest economic costs of cancers in absolute terms, accounting for 24.1% and 20.8% of the total global burden, respectively. Although 75.1% of cancer deaths occur in LMICs, their share of the economic cost of cancers is lower at 49.5%. The relative contribution of treatment costs to the total economic cost of cancers is greater in high-income countries than in low-income countries.
The authors commented that economic cost and health burden of cancers are distributed unevenly across cancer types and across countries. High-income countries bear the highest macroeconomic costs. However, LMICs bear the preponderance of the human toll, underscoring the need for improvements on multiple fronts, including health system strengthening and public health policies to reduce tobacco use. Otherwise, as LMICs develop, an economic cost will accompany the human cost they already incur. The study emphasises the need to invest in global efforts to contain the cancer burden.
In an accompanied editorial, Dr. Gilberto Lopes of the Sylvester Comprehensive Cancer Center at the University of Miami in Miami, FL, US wrote that the study authors bring forward a current estimate of the global economic cost of cancer. However, there is a need to apply all that we already know to address the problem if we want to make a dent on the rising economic global cost of cancer. The time is now to implement the actions that would include the establishment and development of universal health coverage infrastructure with well-trained human capital, the creation and implementation of national cancer control plans, including the establishment and improvement of cancer registries and data repositories on cancer risk factors and treatment outcomes, tobacco control, vaccination against the most common viruses that cause cancer, including human papillomavirus and hepatitis B, and the promotion of healthy diets, exercise, and obesity control. In addition, resource-stratified evidence-based screening, diagnosis, and treatment of common cancers and the creation of reference cancer centres, access to essential cancer medicines, and access to palliative care, especially pain control, are needed.
This research received funding from the National Institute on Aging, National Institutes of Health award. It was also supported by funding from the Chinese Academy of Engineering, the Chinese Academy of Medical Sciences & Peking Union Medical College, Horizon Europe, and the Bill & Melinda Gates Foundation.