Productivity Costs Of Cancer Mortality In The United States: 2000-2020

February 23, 2009 at 8:00 am Leave a comment – In the Journal of the National Cancer Institute, Dr. Cathy Bradley and associates reported a model that predicts the economic benefit of decreased cancer death. She and her team pointed out the many factors that contributed to the 1.1% decrease in cancer mortality between 1993 and 2002, but that the economic gain from these efforts were variable. It could have implications for resource allocation to particular tumor types and treatments.

The investigators employed a human capital method as a means to calculate the expected lifetime earnings that would have been realized had the cancer or death been avoided. It assumes that earnings reflect underlying productivity, and does not measure the value of a life, only the value of labor.

They estimated the costs of cancer deaths that occurred or are predicted to occur between 2000 and 2020. The authors provided the following example of the model; the life expectancy of a 35 year old man in year 2000 is 42.2 years. If this man died at age 35, he would have a .93 probability of employment and his average annual full-time earnings with fringe benefits would be $56,519. If he lived, his probability of employment would have decreased to 0.87 at age 50, but his annual average earning would have increased to $87,706 in the year 2015. Employment probability would continue to decrease as he aged, and employment probabilities and expected earnings were adjusted throughout the lifetime of the individual in the model.

In addition, the researchers estimated the value of informal caregiving and household activities to the base model by imputing a wage for the hours spent in these activities. Numerous databases were used to acquire data for the model; the US Census Bureau, US death certificate data, cohort life tables from the Berkeley Mortality Database, Current Population Survey (CPS), the National Human Activity Pattern Survey and the Caregiving in the US study.

The person-years of life lost (PYLL) were estimated and summed into 5-year age groups. Data revealed that 21% of the US population age 18 and older are engaged in care giving activities including housekeeping chores for another individual who is 18 years or older. Ten percent of these caregivers provide more than 40 hours per week of care. In year 2000 the present value of lifetime earnings (PVLE – the sum of productivity costs and the sum of imputed value of caregiving) that was lost due to cancer deaths was $115.8 billion. This increased to $147.6 billion in year 2020. Total PVLE and PVLE lost per death by cancer site for the year 2010 were computed. Lung cancer deaths accounted for more that 27% of the total costs ($39 billion), followed by colon and rectal cancers, and female breast cancer.

Regarding GU malignancies, kidney and renal pelvic cancer, prostate cancer, urinary bladder cancer, and testes cancer accounted for 2.55%, 2.48%, 1.39%, and 0.33% of the percentage of total PVLE cost, respectively. The PVLE range was $3.6 billion for kidney to $471 million for testes cancers. However, testes cancer was the most costly cancer per death in 2010 due to the effect in younger working-age men. Addition of the value of caregiving and household activities increased costs in the model dramatically. In 2000 the total cost was $232.4 billion (relative to $115.8 billion) and in 2020 the cost increased to $308 billion (relative to $147.6 billion).

This study supports that the costs from premature cancer mortality are substantial. In 2007, the productivity costs from cancer deaths amounted to 1% of the US gross domestic product. Clearly lung cancer dominates the loss of productivity costs.

Bradley CJ, Yabroff KR, Dahman B, Feuer EJ, Mariotto A, Brown ML

J Natl Cancer Inst. 2008 Dec 17;100(24):1763-70


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