Cancer is estimated to have caused more than 600,000 deaths in 2015, inflicting a toll that extended far beyond personal losses to impose an enormous burden on the nation’s economy, according to a new analysis.
Cancer deaths that year — the most recent year for which certain data were available — collectively cut short 8.7 million years of life, a loss that translated to $94.4 billion in lost earnings, the study found.
Dr. Farhad Islami, scientific director of surveillance research at the American Cancer Society and a co-author of the study, said the figures highlight how important cancer prevention is not only for patients but also for the health of the U.S. economy.
“When you invest in cancer prevention, treatment, and screenings, you don’t just save lives,” Islami said. “There are also substantial financial benefits.”
The study, published this week in JAMA Oncology, is not the first to examine the economic burden of cancer deaths. But it used what’s known as a human capital approach, which estimates the effect of cancer deaths on the economy rather than the overall value of life lost, which is called a “willingness-to-pay” approach. Recognizing that cancer mortality varies geographically across the country, the new study also assessed the economic burden in each state.
On the state level, the burden was distributed unequally. After taking into account age and population differences across states, researchers found lower rates of lost earnings in the West. Utah claimed the lowest overall rate at $19.6 million in lost earnings per 100,000 people. Lost earning rates were highest in the South, where Kentucky took the highest share of the burden at $35.3 million per 100,000 people.
If all 50 states had a rate equivalent to Utah’s, approximately 2.4 million years of lost life could have been avoided and $27.7 billion in lost earning saved — a 29% national reduction in lost earnings.
The authors also examined lost earnings by cancer type. Lung cancer topped the charts with total lost earnings of $21.3 billion, followed by colorectal and breast at $9.4 billion and $6.2 billion, respectively. Lost earnings from lung cancer were also higher than losses from any other type of cancer across every single state. This is likely due its prevalence and the poor outcomes associated with the disease.
But, the authors point out, there are opportunities to reduce the burden of cancer deaths — namely by improving cancer prevention. Many of the cancer types examined come with known risk factors, screening techniques, and effective treatments.
Smoking, physical activity level, and diet can help reduce risk factors for these costly cancer types. Utah, for example, has the lowest prevalence of smoking among men.
The authors point out that cancer screening and early detection can also effectively reduce mortality rates for some cancer types, including colorectal and breast. But not everyone takes advantage of or has ready access to care.
The proportion of people who are up-to-date on recommended screenings varies by state. A 2018 study by the Centers for Disease Control and Prevention found that in 2016, only 67% of eligible adults were up to date with colorectal cancer screening. Similar disparities among states when it comes to the delivery of effective treatments and rates of vaccination for human papillomavirus. Implementing prevention measures and improving access to high-quality care could, the authors said, prevent deaths and alleviate the economic burden of cancer.
“These types of analyses help us prioritize where to put our resources,” said Cathy Bradley, associate dean for research and deputy director of the University of Colorado Cancer Center, who reviewed the study but was not involved in the work. “We want to allocate the limited resources we have to diseases and conditions with the biggest impact. And productivity is one way of measuring the impact.”
The actual productivity loss may be higher than $94.4 billion. The authors note their analysis did not include people younger than 16 or older than 85. They also estimated life expectancies based on data that included all causes of death, and average life expectancies would likely be higher in the absence of cancer.
Bradley said there is more important work to do in this area, including by incorporating race and ethnicity into analyses. Regardless, she said, the new study does demonstrate how reductions in cancer mortality could bring financial payoffs.
“If we can all get our risk factors down, look at the benefits that could be achieved,” Bradley said. “Investments in prevention and control are apparently very worthwhile. And I think the study does a good job of demonstrating that.”