Cancer Has Greater Economic Impact Than All Other Diseases

Zosia Chustecka

August 25, 2010

August 25, 2010 — Cancer has a greater economic impact from premature death and disability than all causes of death worldwide, according to a report from the American Cancer Society and the LIVESTRONG organization.

Using data from the World Health Organization (WHO), it concludes that cancer "has the most devastating economic impact of any cause of death in the world."

The report, released last week at the 2010 World Cancer Congress in Shenzhen, China, was authored by American Cancer Society researchers Rijo M. John, PhD, and Hana Ross, PhD, who are both involved in international tobacco-control research.

If we act quickly, we have the opportunity to avert needless deaths and suffering from cancer.

In recent years, the global health agenda has been dominated by public health issues such as HIV/AIDS, tuberculosis, malaria, maternal/child health, and malnutrition, and "these efforts are notable," the authors note.

"As more data like this are accumulated, we must press for additional resources to combat cancer and to build a more balanced global health portfolio," they explain.

"If we act quickly, we have the opportunity to avert needless deaths and suffering from cancer and to reduce its devastating impact," they add.

First Study on a Global Scale

This study is the first substantive effort to quantify economic loss due to cancer and other disease on a global basis, the researchers report.

Previous studies examining the economic impact have been limited to a handful of high-income countries, they write. But high-income countries represent only 15% of the world's population. Another 9% are classed as upper-middle income, but the majority of the world's population (76%) lives in lower- and middle-income countries that have a gross domestic product (GDP) of less than $3255 per capita.

The report used WHO computations to determine disability-adjusted life-years (DALY), which combine the years of life lost by premature death and the years lived with a disability resulting from the disease. This measure has been criticized, the authors acknowledge, because the disability weights can highly influence the score for some diseases, but it is used by the WHO and other global heath groups, they point out.

In addition, the economic value of a year of healthy life was calculated using a method employed by the WHO Commission on Macroeconomics and Health, which takes into account GDP.

Cancer Beats Heart Disease

Using both methods, the authors estimate that the total economic impact of premature death and disability from cancer worldwide was $895,000 million in 2008.

This is nearly 19% higher than heart disease, the second leading cause, at $753,000 million.

There is a much bigger jump down to the next diseases, with stroke having a global impact of $298,000 million, and diabetes and road traffic accidents both at $204,000 million. This is followed by chronic obstructive pulmonary disease at $203,000 million and HIV/AIDS at $193,000 million.

Much lower down the list are infectious disease such as tuberculosis ($45,000 million) and malaria ($25,000 million).

Which Cancers Have the Greatest Impact?

Worldwide, the top 3 cancers that accounted for the most lost years of life were lung cancer (15.5%), stomach cancer (9.6%), and liver cancer (8.6%).

The top 3 cancers that had the greatest economic impact globally were lung cancer ($188,000 million), colorectal cancer ($99,000 million), and breast cancer ($88,000 million).

These distributions vary somewhat among different countries, as would be expected, the authors note. When the impact was calculated for the different regions of the world, according to both DALYs lost and economic value lost, the cancers with the greatest impact were lung, colorectal, and breast cancers in high-income and upper-middle-income countries; lung, stomach, and liver cancers in lower-middle-income countries; and mouth/oropharyngeal, cervical/uterine, and breast cancers in low-income countries.

The authors highlight 2 of these findings.

First, lung cancer takes a high toll in nearly all nations, so international programs to reduce tobacco could have a significant impact, they explain.

Second, the impact of cervical cancer in low-income countries is "disproportionate and compelling," they write, because most cases of cervical cancer can be prevented or treated effectively.

Routine screening and treatment of cervical cancer has been available for more than 50 years, and in high-income countries, rates of this disease have dropped dramatically. "Unfortunately, the majority of women in low-income countries do not have access to [such] care," they point out.

This finding should "give added emphasis to the WHO's initiatives to expand cervical cancer prevention and control programs in developing nations" the authors write.