Global Cost of Cancer at $25 Trillion; How to Reduce This?

Cancer continues to be one of the leading causes of death with nearly 10 million cancer-related deaths worldwide in 2020, according to the World Health Organization (WHO). Cancer is also responsible for the highest economic loss compared with other leading causes of death across the globe. 

A new study estimates the global economic cost of cancer to amount to $25.2 trillion (international dollars at constant 2017 prices) from 2020 to 2050, taking into account treatment of 29 cancer types across 204 countries and territories. However, the economic burden and the health burden were distributed unequally across countries, world regions, and country income groups.  

The authors, led by Simiao Chem, ScD, from the Heidelberg Institute of Global Health, Heidelberg, Germany, call for more investment in cancer screening, diagnosis, and treatment. 

“Our findings suggest that investing in effective public health interventions to reduce the burden of cancers is essential for protecting global health and economic well-being,” they write.

“The WHO and the United Nations have issued important guidance for responding to the burden of cancer through increased investment and thoughtful prioritization of relevant policy initiatives,” the researchers note, “but few countries have made meaningful progress toward international targets for cancer and noncommunicable disease reduction.”

The study was published online February 23 in JAMA Oncology. 

The team used a macroeconomic model to quantify the cost of 29 cancers, including the association of cancer-related mortality and morbidity with labor supply and the diversion of cancer treatment expenses from savings and investments. 

The five cancer types with the highest economic costs were tracheal, bronchus, and lung cancer at INT $3.9 trillion, colon and rectum cancer (INT $2.8 trillion), breast cancer (INT $2 trillion), liver cancer (INT $1.7 trillion) and leukemia (INT $1.6 trillion). 

When the team focused on individual countries, they found that China faces the largest economic cost of cancers at INT $6.1 trillion, followed by the United States with INT $5.3 trillion. The largest burden in both China and the US comes from tracheal, bronchus, and lung cancer. As expected, the cost is skewed toward high-income nations, despite three quarters of deaths occurring in low- and middle-income countries.

In an accompanying editorial, Gilberto Lopes, MD, MBA, associate director for global oncology at the Sylvester Comprehensive Cancer Center in Miami, Florida, commented that estimating the global cost is just the first step, and urged action to reduce the burden. Actions needed to improve cancer control worldwide include the establishment and development of universal health coverage infrastructure, the creation and implementation of national cancer control plans and vaccination against the most common viruses that cause cancer, as well as tobacco control and the promotion of healthy diets, exercise and obesity control. 

“Indeed, an investment of US$11.4 billion in a set of core prevention strategies in lower resourced regions of the world has been estimated to potentially lead to savings of up to US$100 billion in future cancer treatment costs,” Lopes writes. 

“We need to apply all we already know to address the problem if we want to make a dent on the rising economic global cost of cancer,” he adds. “The time is now.”

This study was funded by the National Institute on Aging, the National Institutes of Health, the Chinese Academy of Engineering, the Chinese Academy of Medical Sciences & Peking Union Medical College, Horizon Europe, and the Bill & Melinda Gates Foundation. The study authors report no relevant financial relationships.

Editorialist Lopes reports potential conflicts outside the scope of this article, including stock and other ownership interests in Lucence Diagnostics and Xilis; honoraria from Boehringer Ingelheim, Blueprint Medicines, AstraZeneca, Merck, and Janssen; consulting or advisory role for Pfizer and AstraZeneca; research funding for AstraZeneca, Lucence, Xilis, E.R. Squibb & Sons, LLC, Merck Sharp & Dohme, EMD Serono, AstraZeneca, Blueprint Medicines, Tesaro, Bavarian Nordic, NOVARTIS, G1 Therapeutics, adaptimmune, BMS, GSK, AbbVie, Rgenix, Pfizer, Roche, Genentech, Lilly, and Janssen; travel, accommodations, expenses from Boehringer Ingelheim, Pfizer, E.R. Squibb & Sons, LLC, Janssen, Seattle Genetics, Celgene, Ipsen, Pharmacyclics, Merck, AstraZeneca, and Seagen; and other relationship with Mirati Therapeutics.

JAMA Oncology. Published online February 23, 2023. Full text, Editorial

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