The cost of premature cancer-related mortality: a review and assessment of the evidence

Abstract

Worldwide, 8.2 million people die of cancer annually. Cancer has a significant societal impact, impinging on countries' economic health. We reviewed methodological aspects, and the main cost results, of studies calculating premature mortality losses from cancer published 2000–2013 and identified gaps in the evidence-base. Thirty-one studies were identified (Europe, 17; USA, 11; Korea, 2; Puerto Rico, (1). The human capital approach dominated (30 studies); studies differed in how they implemented the methodological approach. Aspects of methodology were poorly reported. Premature cancer-related mortality costs are substantial and appear to be rising. The evidence-base has gaps in relation to cancer sites studied and less developed and emerging economies. Comprehensive, standardised, estimates of premature mortality losses are needed if these measures are to be useful in assessing the societal cancer burden.

Keywords::

• cancer
• economic burden
• premature mortality
• productivity costs
• societal

Financial & competing interests disclosure

We appreciate the support of COST Action IS1211 CANWON. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Cancer has a significant societal impact and impinges on the economic health of a country.

• A growing trend in estimating cancer-related productivity losses, with a particular focus on cancer-related premature mortality costs, has emerged in recent years.

• In all settings considered, the cost of premature cancer-related mortality was substantial, whether expressed in terms of total cost or cost per death or incident case.

• There appears to be an upward trajectory in cancer-related premature mortality both for all cancers combined and for specific cancer sites.

• Unpaid work in the form of household activity, caring and volunteer work has not been included in the majority of studies resulting in an underestimation of ‘true' societal costs.

• Differences in the upper age cutoff threshold for cost measurement and lack of detail about how/whether labor market parameters were accounted for is evident in the literature.

• Important gaps remain including the range of cancer sites studied and the lack of estimates for less developed and emerging economies.

• The priority for the coming 5 years should be to improve the quality and quantity of cancer-related premature mortality cost estimates in order to allow increasingly meaningful use of this information by policy-makers.

Notes

1 In relation to premature mortality costs, an incidence-based cost approach considers the productivity lost throughout the lifetime of those who died from cancer in a specific year, while a prevalence-based costs approach considers the lost productivity in a certain year for those who would have been alive in that year if they had not died, either in that year or previous years, from cancer [29].