Productivity Costs of Cancer Mortality in the United States: 2000–2020

Department of Health Administration, Massey Cancer Center, Virginia Commonwealth University, 1008 E. Clay Street, P.O. Box 980203, Richmond, VA 23298, USA.
Journal of the National Cancer Institute (Impact Factor: 12.58). 01/2009; 100(24):1763-70. DOI: 10.1093/jnci/djn384
Source: PubMed


A model that predicts the economic benefit of reduced cancer mortality provides critical information for allocating scarce resources to the interventions with the greatest benefits.
We developed models using the human capital approach, which relies on earnings as a measure of productivity, to estimate the value of productivity lost as a result of cancer mortality. The base model aggregated age- and sex-specific data from four primary sources: 1) the US Bureau of the Census, 2) US death certificate data for 1999-2003, 3) cohort life tables from the Berkeley Mortality Database for 1900-2000, and 4) the Bureau of Labor Statistics Current Population Survey. In a model that included costs of caregiving and household work, data from the National Human Activity Pattern Survey and the Caregiving in the U.S. study were used. Sensitivity analyses were performed using six types of cancer assuming a 1% decline in cancer mortality rates. The values of forgone earnings for employed individuals and imputed forgone earnings for informal caregiving were then estimated for the years 2000-2020.
The annual productivity cost from cancer mortality in the base model was approximately $115.8 billion in 2000; the projected value was $147.6 billion for 2020. Death from lung cancer accounted for more than 27% of productivity costs. A 1% annual reduction in lung, colorectal, breast, leukemia, pancreatic, and brain cancer mortality lowered productivity costs by $814 million per year. Including imputed earnings lost due to caregiving and household activity increased the base model total productivity cost to $232.4 billion in 2000 and to $308 billion in 2020.
Investments in programs that target the cancers with high incidence and/or cancers that occur in younger, working-age individuals are likely to yield the greatest reductions in productivity losses to society.

Download full-text


Available from: Robin Yabroff,
    • "Among cancers colorectal cancer has the second highest productivity losses in the EU, followed by breast cancer (Luengo-Fernandez et al., 2013). This is also confirmed by a similar study in the US (Bradley et al., 2008). For diabetes type II, the CODE-2 study (Cost of Diabetes in Europe-Type II) showed that for Belgium yearly direct treatment costs for patients were equal to 1505 euro when no complications are diagnosed, 2563 euro when microvascular complications take place, 3148 euro in case of macrovascular complications (coronary heart disease, cerebrovascular disease). "
    [Show abstract] [Hide abstract]
    ABSTRACT: In Flanders, a European hot spot for air pollution, alternatives to car transport are put in place to increase the daily level of physical activity (PA) among the population and reduce air pollution and global warming. To evaluate the economic impact of increased PA (cycling and walking), a health impact model was developed for a given volume of PA, relative to car use, within a defined population in Flanders. Flanders is an interesting region because of the combination of high air pollution, high cycling volumes and good data availability e.g on crashes and PA. The model uses two health indicators: external costs and DALYs. Considered impacts in the model are: mortality and morbidity related to increased PA, air pollution exposure for society and active individuals and crash risks. In addition to health, external costs for CO2 emission, congestion and noise exposure can be considered. The model was applied to the new bicycle highways Antwerp-Mechelen and Leuven-Brussels, which were built near important traffic axes to provide the densely populated region with an alternative to car use. Different sensitivity analyses with a variable number of cyclists and travelled distances were elaborated to check the robustness of the results. Overall, the conclusion was that increased PA outweighed other impacts. The benefit:cost ratio for health impact and infrastructure construction costs was mainly positive, even with conservative assumptions and when the impacts of congestion, noise and reduced CO2 were not accounted for. When reduced congestion was added to the model, benefit:cost ratios largely exceeded one. The model can be used in a retrospective way to analyse previous investments or can be applied to new policy decisions. The presented model is tailored here to the Flemish context for crash risks and air pollution but parameters can easily be adapted to reflect conditions in other regions. Model: Article already available at:
  • Source
    • "Similarly, a study assessing earnings lost as a measure of productivity found that in 2010, the value of lost productivity due to HNC was US$3.4 billion. Based on projected growth and aging of the US population, productivity costs will increase if cancer mortality rates are constant in the future [86]. In addition, a French study examining the “social” burden of laryngeal cancer attributable to occupational exposure to asbestos reported that direct costs for this condition ranged from €35.3 million to 57.6 million, while indirect costs were €17.5 million to 34.9 million (2010 €) [87]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Head and neck cancer (HNC) and its treatment can affect communication, nutrition, and physical appearance, and the global impact of this disease on patients' quality of life may be substantial. Objective: The aim of this systematic literature review was to describe the impact of HNC and its treatment on the physical, emotional, and social well-being of patients over time, by examining longitudinal studies of patient-reported outcomes (PRO) evaluating these domains. Methods: Databases (MEDLINE and Embase) were searched to identify studies published in English between January 2004 and January 2014 analyzing the humanistic aspects of HNC in adult patients. Additional relevant publications were identified through manual searches of abstracts from recent conference proceedings. Results: Of 1,566 studies initially identified, 130 met the inclusion criteria and were evaluated in the assessment. Investigations using a variety of PRO instruments in heterogeneous patient populations consistently reported that PRO scores decrease significantly from diagnosis through the treatment period, but generally recover to baseline in the first year post-treatment. This trend was observed for many functional domains, although some side effects, such as xerostomia, persisted well beyond 1 year. In addition, considerable evidence exists that baseline PRO scores can predict clinical endpoints such as overall and progression-free survival. Conclusions: Many aspects of HNC, both disease and treatment specific, profoundly affect patients' quality of life. Improved knowledge of these effects on PRO may allow for more informed treatment decisions and can help physicians to better prepare patients for changes they may experience during therapy. Furthermore, the predictive value of baseline PRO data may enable healthcare providers to identify at-risk patients in need of more intensive intervention.
    PharmacoEconomics 05/2014; 32(9). DOI:10.1007/s40273-014-0169-3 · 2.45 Impact Factor
  • Source
    • "A wider study done in a population with different kinds of cancer showed the same results45). The financial impact in the USA resulting from cancer was reported in the study of Bradley et al.46), which predicts prevention measures for the disease in the younger economically active population. In Brazil, breast cancer has presented the highest rate of incidence (61.9:100,000) among sickness benefitsgiven in 2006, compared to all the others in different localizations (by age)47), which represented a high impact in the social security. "
    [Show abstract] [Hide abstract]
    ABSTRACT: [Purpose] The aim of this study was to evaluate the functionality of women diagnosed with breast cancer according to the International Classification of Functioning, Disability and Health (ICF). [Subjects and Methods] This was a cross-sectional study. We applied instruments consistent with the summary of ICF codes for breast cancer: quality of life questionnaire (WHOQOL), upper limb symptoms and function (DASH), social support, physical examination and functional medical record data. [Results] The study included 105 women who were 55 years old and subjected to surgical treatment within an average of 1.63 year previously. The 'function' component considered in the WHOQOL, the DASH and physical examination. There were high prevalences of positive responses for most codes, and only b130, d430, d445, d640, d650, d920 and codes of environmental factors considered by the Social Support Questionnaire showed high prevalences of negative responses (47.6%, 61%, 43.8%, 63.8%, 56.2%, 52.4%, and 35.2%, respectively). [Conclusion] There was a lower prevalence of disability, with the exception of issues related to strenuous activity and load. Some findings showed conflicting results between different instruments that measure the same code, and studies that propose more accurate tools and are able to consider the ICF codes specific to this pathology are necessary.
    Journal of Physical Therapy Science 05/2014; 26(5):721-30. DOI:10.1589/jpts.26.721 · 0.39 Impact Factor
Show more