In a new analysis, researchers examined the estimated cost of lost earnings that resulted from cancer-related deaths in the United States, nationally and by state. This study is not the first to examine the economic burden of cancer deaths in the United States. However, the study does provide contemporary estimates of person-years of life lost (PYLL) as a result of cancer deaths and the associated lost earnings at the national and state levels for all cancers combined (Islami F, et al. JAMA Oncol. 2019 Jul 3 [Epub ahead of print].).
“Contemporary comprehensive information on the economic burden associated with cancer mortality at national and state levels could be used in setting policies and prioritizing resources for cancer prevention and control,” said the researchers.
Cancer has been projected to cause more than 606,000 deaths in the United States in 2019. In addition to the clinical burden, cancer deaths impose a substantial economic toll on the United States because of productivity losses from premature death.
For this population-based study, the researchers used mortality data from the National Center for Health Statistics, and earnings data from the US Census Bureau’s 2016 Current Population Survey’s March Annual Social and Economic Supplement. PYLL were calculated using the number of cancer deaths and life expectancy data in individuals aged 16 to 84 years who died of cancer in the United States in 2015. The annual median earnings in the United States were used to assign a monetary value for each PYLL by age and sex.
“Person-years of life lost and lost earnings were high for many cancers associated with modifiable risk factors and effective screening and treatment, suggesting that a substantial proportion of the mortality burden is potentially avoidable,” the researchers emphasized.
Cancer took more than 8.7 million PYLL from persons aged 18 to 64 years in 2015, translating to $94.4 billion in lost earnings, with a rate of $29 million per 100,000 persons and mean lost earnings of $191,900 per cancer death. Lung cancer had the highest lost earnings ($21.3 billion), followed by colorectal cancer ($9.4 billion), female breast cancer ($6.2 billion), and pancreatic cancer ($6.1 billion). Lost earnings from lung cancer were also higher than losses from any other type of cancer across all 50 states.
At the state level, the financial burden was distributed unequally. Factoring in age and population differences across the states, the lowest rates of lost earnings were in the West. Utah had the lowest overall rate, at $19.6 million, in lost earnings per 100,000 people. Lost earning rates were highest in the South, with Kentucky topping the largest share of the burden, at $35.3 million per 100,000 people. Approximately 2.4 million PYLL and $27.7 billion in lost earnings would have been avoided in 2015 if every state had the same age-specific PYLL or lost earning rates as Utah, the researchers noted.
“Although exposure to modifiable risk factors, cancer screening, and high-quality treatment can be further improved in Utah, even achieving Utah’s present age-specific lost earning rates by other states could reduce lost earnings from cancer deaths by 29% nationally and by as much as 47% in Kentucky and Mississippi,” wrote the researchers.
“Implementation of comprehensive cancer prevention interventions and equitable access to high-quality care across all states could reduce the burden of cancer and associated geographic and other differences in the country,” concluded the researchers. “Health care professionals can contribute to achieving this goal because they play a central role in the delivery of cancer prevention, screening, and treatment.”
