Economic Impact Report
The Global Burden of Cancer
Cancer. The word is ripe with meaning. The mystery and stigma associated with the disease is so great that in some societies and cultures the word is rarely used and the illness never discussed. There is tragic irony in that. Cancer is widespread. It is the second-leading cause of death and disability in the world, behind only heart disease. Based on the most complete and current data available, cancer accounts for one out of every eight deaths annually (Mathers and Loncar. 2006). More people die from cancer every year around the world than AIDS, tuberculosis and malaria combined. Cancer deaths occur with nearly six times the frequency of traffic fatalities on an annual basis, and 42 times the frequency of deaths from injuries suffered in war. While at one time the disease was widely thought to afflict only the elderly in affluent countries—where it was seen as a death sentence—cancer has now moved beyond high income countries of the developed world. In the low and middle income countries of the developing world the consequences of the growing burden of new cancer cases and deaths is expected to continue to worsen (Boyle and Levin [eds.] 2008).
Cancer is a global challenge. Even while the world is awakening slowly to the growing burden of cancer—which is like a wave that is still building—far too little is being spent globally to manage the growing crisis. In the developed world, much spending on cancer research and cancer control is fragmented and uncoordinated. The expenditures associated with cancer management and control may represent a share of total health spending that is below the proportion of the total health burden represented by cancer. In the developing world, the crisis is worsening.
What This Report Does
This report examines the global burden of cancer in detail based on estimates of new cases of cancer and associated costs. It presents estimates of more than two dozen cancers by site, sex and geography in 2009 and projected to 2020. Epidemiologic measures such as incidence (the number of new cases during a specific period of time) and case fatality rates (an approximation of how many new cancer cases will result in deaths) are employed to provide detail by country-income group and geographic region, as well as for the world. Next, the report estimates the global economic burden of new cancer cases in 2009. The analysis considers medical and non-medical costs as well as lost productivity. The cost of cancer research is also considered.
Subsequent to this "monetization" of the global burden of cancer, the report examines costs associated with cancer control, including expansion of measures to achieve a global treatment expenditure standard. Achieving that standard would set spending across countries to levels based on estimated costs of treatment in the country with the lowest case fatality rate for each site-specific cancer. Aggregate costs associated with the global treatment expenditure standard represent the "gap" between present-day spending and what is required to treat all cancers at the same level as the global standard. Descriptions of the methodologies employed for all analyses are included. This report concludes with a discussion of the challenges and the many opportunities relating to global cancer control. If implemented, many cancer prevention and control efforts will have positive effects on other chronic diseases that are also growing around the world.