The Burden, Future Trends, And Economic Impact Of Lung Cancer In Saudi Arabia

Figures & data

Table 1 Characteristics Of Patients Diagnosed With Lung Cancer In Saudi Arabia, 1999–2013 (N=6404)

	Factor	N	%
Year	1999	294	4.8
	2000	270	4.4
	2001	194	3.2
	2002	297	4.9
	2003	328	5.4
	2004	359	5.9
	2005	455	7.5
	2006	431	7.1
	2007	534	8.8
	2008	469	7.7
	2009	490	8.1
	2010	520	8.6
	2011	587	9.7
	2012	611	10.1
	2013	565	9.3
Gender	Female	1,511	23.6
	Male	4,893	76.4
Age	<30 years	134	2.1
	30–344 years	596	9.3
	45–59 years	1,902	29.7
	60–64 years	935	14.6
	≥65 years	2,837	44.3
Nationality	Non-Saudi	1,479	23.1
	Saudi	4,925	76.9

Table 2 Association Between New Cases Of Lung Cancer And Gender, Nationality, Age, And Year Of Diagnosis

Cases	aIRR	Robust Std. Errors	Z	P>z	95% Wald Conf. Interval For aIRR
					Lower	Upper
Constant	2.138	0.253	6.410	<0.001*	1.694	2.697
Gender (female = reference)
Male	3.130	0.154	23.250	<0.001*	2.843	3.447
Nationality (non-Saudi = reference)
Saudi	3.104	0.158	22.320	<0.001*	2.810	3.429
Age group (age 45–59 = reference)
Age < 30	0.028	0.003	−30.310	<0.001	0.022	0.035
Age 30–44	0.274	0.023	−15.540	<0.001	0.233	0.322
Age 60–64	0.840	0.049	−2.990	0.003*	0.750	0.942
Age ≥ 65	1.140	0.076	1.980	0.048*	1.001	1.299
Year of diagnosis (1999 = reference)
2000	0.892	0.126	−0.810	0.419	0.676	1.177
2001	0.708	0.116	−2.110	0.035*	0.513	0.976
2002	1.054	0.146	0.380	0.707	0.802	1.384
2004	1.192	0.149	1.400	0.160	0.933	1.523
2005	1.671	0.221	3.890	<0.001*	1.290	2.165
2006	1.574	0.212	3.360	0.001*	1.209	2.051
2007	1.810	0.234	4.600	<0.001*	1.406	2.331
2008	1.534	0.194	3.380	0.001*	1.197	1.966
2009	1.778	0.226	4.530	<0.001*	1.386	2.281
2010	1.850	0.232	4.910	<0.001*	1.447	2.366
2011	2.024	0.278	5.130	<0.001*	1.546	2.650
2012	2.152	0.282	5.840	<0.001*	1.664	2.782
2013	2.013	0.251	5.620	<0.001*	1.577	2.570

Notes: *Significant at α=0.05.

Abbreviation: aRR, adjusted incidence rate ratios.

Figure 1 Lung cancer cases (1999–2013), trend, and forecast (2014–2030) in Saudi Arabia. The cases were summarized from the national-level cohort report utilizing data from the Cancer Registry of Saudi Arabia. The figure depicts a line that best fits the data.

Table 3 Extrapolation Of Lung Cancer Cost In Saudi Arabia

Computed Values And Parameter Assumptions	Values	Sources
ASR/100,000, Saudi Arabia	5.6	Literature
ASR/100,000, United States	36.1	American Lung Cancer Association
ASR/100,000 (1994–2015) average annual growth, Saudi Arabia	3%	Authors’ compilation from literature
5-year survival rate, Saudi Arabia	8%	Salim, et al (2011)^Citation18
5-year survival rate, United States	18.6%	American Lung Cancer/NCI
Purchasing Power Parity (PPP) Conversion, Saudi Arabia	1.378	World Bank
Purchasing Power Parity Conversion, United states	1	World Bank
Lung cancer cost (2015), United states	$13.4	NCI, NIH
Lung cancer lost productivity (2015), United states	$36.1	NCI, NIH
Healthcare expenditure as % of GDP, United states	16.8%	World Bank
Healthcare expenditure as % of GDP, Saudi Arabia	5.8%	World Bank
Health expenditure per capita, United States	$9,536	World Bank
Health expenditure per capita, Saudi Arabia	$1,194	World Bank
GDP per capita, United States	$56,444	World Bank
GDP per capita, Saudi Arabia	$20,733	World Bank
Non-health GDP per capita, United States	$46,908	Authors’ computation
Non-health GDP per capita, Saudi Arabia	$19,539	Authors’ computation
Certainty factor	0.5	Literature
Estimated cost lung cancer care management cost (2015), Saudi Arabia	$0.52	Authors’ computation
Estimated lung cancer lost productivity (2015), billions, Saudi Arabia	$3.15	Authors’ computation
Total estimated lung cancer burden (2015), billions Saudi Arabia	$3.67	Authors’ computation

Table 4 Future And Present Value Estimated Cost Of Lung Cancer Care Management And Productivity Loss

Year		Cancer Care Management		Productivity Loss
		Cost ($ millions) Undiscounted & 3% Incidence Growth	Cost ($ millions) In 2015 Values & Discounted At 5% Rate	Cost ($ millions) Undiscounted & 3% Incidence Growth	Cost ($ millions) In 2015 Values & Discounted At 5% Rate
Beginning year = 0	2015	520	520	1970	1970
1	2016	540	510	2030	1930
2	2017	550	500	2090	1890
3	2018	570	490	2150	1860
4	2019	590	480	2210	1820
5	2020	600	470	2280	1790
6	2021	620	460	2350	1750
7	2022	640	460	2420	1720
8	2023	660	450	2490	1690
9	2024	680	440	2570	1660
10	2025	700	430	2640	1620
11	2026	720	420	2720	1590
12	2027	740	410	2810	1560
13	2028	760	410	2890	1530
14	2029	790	400	2980	1500
15	2030	810	390	3070	1470
Total		10,500	7240	39,670	27,360

Notes: Years – represent time and depict the number of years from the beginning year/current year 0, i.e. 2015 to 15, the end of forecasting period (2030).

Table 5 Sensitivity And Adjusted Sensitivity Of Lung Cancer Burden ($ billions) (2015–2030)

	Variability	ASR	Non-Health GDP Per Capita	Discount rate	5-Year Survival Rate	Health Expenditure % GDP
	Panel A	Parameter assumptions and base values
A	20% Reduction	4.4	$15,631	4.0%	6%	4.6%
B	Base scenario	5.6	$19,539	5.0%	8%	5.8%
C	20% Increase	6.9	$23,447	6.0%	10%	7.0%
	Panel B	Sensitivity analysis
D	20% Reduction	$27.19	$29.13	$37.07	$41.45	$33.16
E	Base scenario	$34.61	$34.61	$34.61	$34.61	$34.61
F	20% Increase	$42.64	$40.08	$32.39	$30.04	$36.05
	Panel C	Adjusted sensitivity analysis
G = (D–E)	20% Reduction	-$7.42	-$5.47	$2.47	$6.84	-$1.45
H	Base scenario	-	-	-	-	-
I = (F–E)	20% Reduction	$8.03	$5.47	-$2.22	-$4.56	$1.45
J = Abs (G–I)	Range	$15.45	$10.95	$4.69	$11.40	$2.90
K = Rank of J	Rank	1	3	4	2	5

Figure 2 A Tornado diagram depicting the sensitivity of estimated burden of lung cancer ($ billions) with respect to epidemiologic and economic factors.

Salim EI, Jazieh AR, Moore MA. Lung cancer incidence in the arab league countries: risk factors and control. Asian Pac J Cancer Prev. 2011;12(1):17–34.21517227

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Data Availability

The data are publicly available at Saudi Cancer Registry (webpage, www.chs.gov.sa), but can only be obtained by research proposal and IRB approval.