Most people will be familiar with the huge impact cancer has as a disease, on patients and their loved ones, but the vast effect the disease also has on society more broadly is less recognized.
In the United States, more than 1.8 million new cancer cases were reported in 2022, and more than 600,000 people in the country died of cancer in 2023, according to the Centers for Disease Control and Prevention (CDC), making it one of the biggest killers in America.
While cancer as an illness has therefore brought suffering and grief to many American families, its impacts are “far more devastating than we think about,” Electra Paskett, a professor of cancer research and director of the Division of Cancer Prevention and Control in the College of Medicine, at Ohio State University, told Newsweek.
“Usually we just consider the patient and family and side effects of treatment, but we also need to include communities and countries in the impact,” she added.
Highlighting this impact, a new study by the International Agency for Research on Cancer (IARC) and other collaborators has revealed the economic extent of the ripple effects cancer has through society.
The authors of the study hope that, in highlighting the “profound loss in societal contributions” caused by cancer-related mortality, it will underscore the “importance of sustained investments into cancer control efforts to not only save countless lives and reduce suffering but also to preserve the functioning of families, communities and societies,” Yek-Ching Kong, one of the authors of the new study and a doctoral student at the IARC, told Newsweek.
The Economic Ripple Effects Of Cancer
The study, published in Journal of the National Cancer Institute on September 24, broadly highlighted the profound economic void left behind when individuals die early from cancer, which the researchers believe shows an interconnection between health and economic stability.
The researchers estimated the global productivity loss caused by premature cancer deaths totaled $566 billion in 2022, which is equivalent to 0.6 percent of the global gross domestic product (GDP).
Premature cancer deaths among men led to $315 billion in societal losses and among women, the figure was $250 billion.
Of the global value, almost one third came from cancer deaths in Eastern Asia ($165 billion), followed by Northern America ($112 billion) and Western Europe ($70 billion), although when considered in relation to the national economy, the burden was heaviest in countries in Eastern Africa and Middle Africa, the study found.
“Differences in productivity loss between countries is largely attributable to differences in cancer risks and outcomes,” Kong said.
The researchers also assessed the productivity loss between both paid and unpaid work, finding that lost contributions from unpaid work were particularly substantial among women, but also considerable among men, with unpaid work accounting for more than 40 percent of the total losses among men in most regions of Europe as well as in Northern America.
“We found that lost contributions from unpaid work, for example, caring for dependents, household work, accounted for almost half (46 percent) of the total value,” Kong said.
As unpaid work is “vital to the functioning of families, communities, and societies,” she said, it was important to the researchers that they were able to include unpaid contributions, as Kong said this provides “a more accurate estimate of the burden of lost societal contributions from early cancer deaths.”
The researchers also found that the largest societal losses were from lung cancer deaths, followed by deaths from breast cancer, liver cancer and colorectal cancer.
“Globally, these cancers are also among the largest cancers in terms of incidence and mortality, affecting a large number of people worldwide,” Kong said.
The risk for these cancer types can be reduced through lifestyle modifications, including tobacco cessation, healthy dietary habits, reducing alcohol consumption, and hepatitis B vaccination, the IARC reported in its press release on the study, adding that this highlighted the “substantial returns on investment of current cancer prevention efforts.”
The cancer types with the highest societal loss per premature death were testicular cancer, melanoma of the skin, and cancers of the brain and central nervous system, which are relatively uncommon, but often affect younger individuals.
There are fewer effective options for prevention or treatment of these cancers, and the IARC said in its press release that this “underscores the importance of continued investment in high-burden cancer types, as well as the substantial societal value of developing better strategies to prevent and treat less-common cancer types.”
To gather the findings, the researchers at IARC reviewed estimates of the loss in societal contributions from premature cancer deaths due to productivity loss among individuals of working age, so aged 15 to 64 years, by sex for 36 cancer sites and across 185 countries.
Is Spending More on Cancer a Long-Term Solution?
It is clear, from this study and other research, that the “cost of cancer is steep,” David H. Howard, a professor in the Department of Health Policy and Management at Emory University told Newsweek. Although, in some ways, this study actually “undersells the burden of cancer,” he added.
Howard said that “the impact on younger populations isn’t as widely appreciated,” as we often think of cancer as a “disease of old age.”
Given its huge economic impact, some experts believe that pouring more resources into cancer detection and screening could save costs long term.
Cathy Bradley, dean of the Colorado School of Public Health and the deputy director of the University of Colorado Cancer Center, told Newsweek this was “absolutely” the case.
“Cancer detected at early stages is easier to treat with greater chances of success, and patients in turn, can return to the workforce,” she said.
She added that much of the disease burden was among women with breast cancer, which she said can be detected early, with effective treatments available.
However, she said that prioritizing prevention, rather than detection, was “the best course of action.”
“Efforts focused on tobacco control, diet, exercise, and environmental exposures will save the most costs over the long-term,” she said.
Dr. Cary Gross, a professor of medicine and public health at Yale University, also agreed that “the best approach to reducing cancer costs is to prevent cancers from developing in the first place.”
He told Newsweek that “we need to double down on prevention efforts, ensuring access to screening tests, vaccines (such as hepatitis B, HPV), anti-tobacco programs, and address the rapid growth of obesity in the U.S.”
However, not all experts are in agreement. Howard said that many studies have assessed the impact of early detection on spending, and they all reach the same answer: “early detection does not save money.”
He said that instead: “screening costs money, diagnosis costs money, treatment costs money, and there are some portion of people who are diagnosed with cancers that would never have become apparent if left undiagnosed and untreated.”
So, while he said that screening “may be good to do because it improves health,” it doesn’t save money.
That said, whether it saves costs or not, the findings of the study still underscore how crucial early cancer detection and screening is—not only for patients but also for society as a whole.
Going forward, Howard said that we “should probably focus more on helping people who are unable to work or who lose spouses who are the family breadwinner, regardless of age,” as a lot of social welfare programs are geared towards helping the elderly.”
Ultimately, even though the impact of cancer on health and well-being are of primary concern, “the economics of cancer care cannot be ignored,” Gross said.
“Although we have seen tremendous breakthroughs in cancer research over the past decade, the life-saving potential of these ground-breaking treatments is too often limited by their prohibitive costs,” he added.
Full Interview Below
Newsweek’s interview with Yek-Ching Kong, one of the authors of the new study and doctoral student at the International Agency for Research on Cancer (IARC).
Q1: Were the costs higher than you anticipated?
“Previous studies included only paid work, or were focused on either a single cancer type, country, or specific region. In our global study that included all cancers, we found that lost contributions from unpaid work, for example, caring for dependents, household work, accounted for almost half (46 percent) of the total value, which is comparable to a prior European study. For women in particular, 60 percent of their lost productivity was from unpaid work. This is because unpaid work, which is vital to the functioning of families, communities, and societies, is still mostly performed by women worldwide. By including unpaid work, we are able to provide a more accurate estimate of the burden of lost societal contributions from early cancer deaths.
“We would like to really highlight that the profound loss in societal contributions found in our study underscores the importance of sustained investments into cancer control efforts to not only save countless lives and reduce suffering but also to preserve the functioning of families, communities and societies.”
Q2: What are the main factors that influenced the productivity costs of premature cancer mortality in different countries?
“Differences in productivity loss between countries is largely attributable to differences in cancer risks and outcomes. Countries with high cancer incidence and mortality risks would experience high productivity loss due to a larger number of people diagnosed with and dying from cancer. Cancer risks may vary due to differences in lifestyle behaviors, genetic predisposition, environmental factors, and occupational risks for example. Meanwhile, cancer outcomes, including mortality risk, are heavily influenced by the availability of effective cancer control programs, such as early prevention and detection, timely diagnosis, and availability and accessibility of appropriate treatments. The mix of different cancer risk factors and cancer control programs in different countries would therefore influence the risks of being diagnosed with and dying from cancer, leading to differences in productivity losses.”
Q3: The findings indicate that the U.S. does not experience as high a productivity loss from premature cancer mortality than a number of other high-income countries, such as Canada—why do you think that is and what do you think that shows?
“In terms of absolute value, total lost productivity is higher in the U.S., at $101,456 million, compared to Canada, $10,821 million, as well as value per cancer death, which is $635,344 per death in the U.S. vs $576,674 per death in Canada. This is due to the larger number of individuals who were diagnosed with and died from cancer in the U.S. when compared to Canada in 2022.
“When examined relative to national GDP in 2022, while the burden of productivity loss was slightly smaller in the U.S., at 0.40 percent of GDP, than in Canada, at 0.51 percent, we believe that this is comparable. The minor difference observed between the U.S. and other high-income countries when examining productivity loss as a proportion of national GDP could be explained by the larger size of the American economy, and thus a higher GDP value in the U.S., compared to the size of the national economy in other settings with smaller GDP values.”
Q4: Why do you think costs are higher for lung, breast and liver cancer?
“In the U.S., more than half a million Americans were estimated to have been diagnosed with lung, breast or liver cancer in 2022. Cancers of the lung, breast and liver were also the among the top causes of death, with more than 200,000 deaths estimated in the U.S. Globally, these cancers are also among the largest cancers in terms of incidence and mortality, affecting a large number of people worldwide. The large number of individuals diagnosed with these cancers and die prematurely from these cancers, especially during their productive years, would thus lead to higher accumulated productivity losses.”