By Hannah Hoag
The High Costs of Cancer Mortality
A new analysis helps put research funding into perspective
By Hannah Hoag
When it comes to calculating cancer’s economic toll, the price tag is far greater than the dollars spent on diagnostic tests, medical care and even cancer research. That’s the message from a pair of studies, published Dec. 17, 2008, in the Journal of the National Cancer Institute, which reveal a substantial economic burden from cancer mortality in the U.S. due to lost wages and lost years of life.
“These studies give decision makers information … about the relative investment and the potential payoffs of investing in cancer research and searching for ways to reduce the burden of cancer for all age groups and all [cancer] sites,” says Cathy Bradley, a health economist at the Virginia Commonwealth University Massey Cancer Center in Richmond, who worked on both studies.
In the first study, researchers estimated the economic burden of cancer deaths by considering the years of lost earnings of those who die prematurely of cancer. The researchers calculated that the annual cost in 2000 was $116 billion—an amount that will increase to an estimated $148 billion in 2020. When the value of uncompensated caregiving and housekeeping duties were also considered, the cost rose to $232 billion in 2000 and $308 billion in 2020.
In a complementary study, the researchers estimated the value of lives lost to cancer by multiplying the number of years of life lost by $150,000—the amount an average person is willing to pay for a year of life, according to previous studies. For example, if an individual with a life expectancy of 85 years died at 68, he would have lost 17 years of life, valued at $2.55 million. According to the researchers’ analysis, the value of lives lost from all cancer deaths was $961 billion in 2000 and will climb to an estimated $1.47 trillion in 2020.
“An important component of cancer cost is this idea that these people die younger than they would otherwise,” says Robin Yabroff, an epidemiologist at the National Cancer Institute (NCI) who, like Bradley, worked on both studies. “People tend to think of health care costs in terms of hospitalizations or doctors visits. But this is another important component.”
The newly derived costs far exceed the direct cost of medical care for cancer patients, which was $89 billion in 2008, as well as the $4.8 billion budget of the NCI last year.
Both of the new studies found that at least 25 percent of cancer’s costs could be attributed to lung cancer. In 2008, an estimated 161,840 people died of the disease in the U.S., far more than died of any other cancer. The researchers further calculated that if lung cancer mortality rates declined by 1 percent annually, the value of life lost in 2020 due to lung cancer would drop from a projected $433 billion to $355 billion. A 4 percent annual decline in these mortality rates would put the estimated value of life lost to lung cancer in 2020 at $192 billion.
“The issue with lung cancer is that we are so naive about what we really know,” says Regina Vidaver, the executive director of the National Lung Cancer Partnership. “We need more knowledge in every single aspect, certainly in understanding [cell] signaling pathways and where they go wrong in cancer initiation and drug-resistance development.”
Even so, Laurie Fenton Ambrose, the president and chief executive officer of the Lung Cancer Alliance, is optimistic that a 1 percent annual decline in mortality is possible with additional funding for lung cancer research, including efforts aimed at finding cancers earlier. “Most cancers that have seen improvements are due to a more robust mechanism to detect their cancers early,” she says.
According to Scott Ramsey, a health economist and a physician at the Fred Hutchinson Cancer Research Center in Seattle, research is vital. “The only way we’re going to chip away at mortality is by developing new technologies,” he says, “and the NCI is the knowledge engine that creates those technologies.”