Investing in cancer control saves lives – and makes financial sense

When people think about the global burden of cancer, what most often comes to mind is the loss of lives and loved ones, or the challenges associated with care and treatment.

Less common is the tendency to view cancer as a threat to global economic stability. 

In 2010, the estimated total annual economic cost of cancer globally was approximately US$ 1.16 trillion, taking into account the costs of prevention and treatment as well as the annual economic value of disability-adjusted life years. Even broader estimates of the total cost – taking into account the longer-term costs to patients and their families – suggest the total global cost of cancer could be closer to US$2.5 trillion.

Despite these figures, the threat that cancer and other non-communicable diseases (NCDs) pose to economic growth and development is only just starting to receive broad attention from governments and intergovernmental organisations around the world.

The 2014 World Cancer Leaders’ Summit, an annual high-level policy meeting of leaders was held in Melbourne in early December. The summit, titled The Economic Case for Cancer Control, sought to form a snapshot of the current global evidence based on the economic costs and the return on investment in adopting strategies for cancer prevention, early detection and health systems strengthening. The summit marked the opening day of the bi-annual World Cancer Congress, also held in Melbourne for the first time.

The takeaway message was clear: not only does investing in cancer control save lives – it makes financial sense for governments around the world.

Professor Sanchia Aranda, president-elect of the Union for International Cancer Control, Director of Cancer Services at the NSW Cancer Institute and a Professorial Fellow at the University of Melbourne, says governments around the world must act to reduce the global economic burden of cancer, particularly in low and middle-income countries.

“The World Economic Forum has identified NCDs as a major threat to world economics, including those of our poorest nations,” Professor Aranda says.

“Cancer is the largest killer amongst NCDs globally. There are 14 million cases of cancer globally, with more than 50 per cent of these occurring in low and middle income countries. Of eight million deaths, around 67 per cent of these occur in low and middle income countries. Despite this reality, most of the global development funds are spent on communicable disease. Low and middle-income countries face the double burden and have the least well-developed and well-resourced health systems.”

A key aim of the summit was to demonstrate that solutions to prevent and manage cancer exist, are accessible in low-resource settings, and most importantly, deliver a return on investment to governments.

Many of the key components making up the case for investment in cancer control discussed at the summit focused on prevention. Prevention strategies discussed included raising tobacco taxes; implementing prevention packages to improve diets and increase physical activity; developing effective workplace health promotion programs; and widespread vaccinations, particularly in low-resource settings where screening and treatment services might not be available. Strong cases were also made for investment in early detection via comprehensive screening programs, and improvements in treatment and care. 

All of these strategies were discussed within the context of the economic benefits they would bring to governments. For example, implementing widespread HPV (human pailloma virus) vaccination programs in low-income countries would significantly reduce the economic costs for governments around the world. In 2010, cervical cancer was estimated to cost the global economy around US$2.7 billion.

“There are 500,000 cases of cervical cancer annually, and 250,000 deaths, and yet this is a fully preventable disease. Australia vaccinates girls for HPV and only has around 1000 new cases [of cervical cancer] a year,” Professor Aranda says.

“The opposite is true in Africa and South America, where access to the vaccine is poor because of costs, but this is where the greatest burden of disease lies. Investment in the prevention and early detection of cervical cancer is economically sensible to reduce the burden of disease in low-income countries, rather than facing the expense of treatment and the loss of productive life, which would have overall, a much greater cost.”

Australia has some of the best cancer outcomes in the world, ranking in the top four globally among a number of benchmarks, including survival rates. However, Professor Aranda notes that even within Australia, significant variations in survival rates still occur among Aboriginal communities, low socio-economic status groups, and those living in remote and rural areas. She says more needs to be done to ensure disadvantaged groups have the same access to services and positive outcomes from care and treatment. 

“We need to do more to ensure our health system does not deliver cancer services that vary because of who you are and where you live,” Professor Aranda says. 

Above all, Professor Aranda says she hopes the 2014 World Cancer Leaders’ Summit helped to build momentum among decision-makers around the world to ensure there was a clear and compelling message around the case for investment – because such investment would not only reduce the global cost of cancer, it would save lives. 

www.uicc.org/convening/world-cancer-leaders-summit/wcls-2014

www.worldcancercongress.org/