By Ed Edelson, HealthDay Reporter
TUESDAY, Dec. 9 (HealthDay News) -- In pure economic terms of productivity lost and the expense of care-giving, cancer deaths cost the United States $232.4 billion in 2000 and will cost $308 billion in 2020, a new report finds.
But another way of measuring that toll includes the human element of years of life lost -- and that model placed the cost of cancer mortality at $960.7 billion in 2000 and projects it to reach $1.472 trillion in 2020.
Those two estimates appear in side-by-side papers published online Dec. 9 in the Journal of the American Cancer Institute. While the numbers differ widely, they are alike in one major respect, said Cathy J. Bradley, a professor of health administration at Virginia Commonwealth University and the Massey Cancer Center in Richmond, Va., and lead author of one of the reports.
"In both cases, the percentage of cost caused by lung cancer was about the same," Bradley said. "Lung cancer accounts for between a quarter and a third of the value of life lost."
The assessment made by Bradley and her colleagues used what is called the human capital approach, which looks strictly at money not earned or money spent because of cancer deaths. Lost productivity cost the country $115.8 billion in 2000. Adding in the cost of care-giving and lost household duties, as well as the loss of regular wage-earning jobs, more than doubled the total of that reckoning.
Robin Yabroff, an epidemiologist at the U.S. National Cancer Institute, and lead author of the second paper, said his "calculation was based on willingness to pay. How much would an individual be willing to pay for an extra year of life?"
Estimates of that figure can vary, depending on the country. The Canadian government, for instance, has set the value of an added year of life at $50,000, a figure it uses to determine whether the national health program will pay for drug treatment, Yabroff said. Her report used previous U.S. studies to set the value of an added year of life at $150,000. That estimate led to the $960.7 billion cost for the year 2000.
"Both of these methods are used in the medical literature," Yabroff said. "We thought it would be useful to compare them."
Large as the costs are, they reflect a decrease in the incidence of cancer in the United States. A National Cancer Institute report issued earlier this month said the rate for all cancers among men and women had dropped 0.8 percent a year between 1999 and 2005 -- a 1.8 percent a year decline for men and a 0.6 percent annual decline for women.
The human capital approach places a higher value on some people than others, Bradley added. For example, "Certain diseases inflict a lower cost because they affect older people more," she said. "Men tend to be valued higher than women, men in their middle years higher than men at the beginning of their career."
The findings could be used to affect cancer spending priorities, Bradley said.
"Policy makers have to decide if we focus on working-age individuals, if we focus on prevention or treatment," she said. "If you get people to stop smoking, 40 years later you see the cost of lung cancer come down. Or perhaps right now you would want to make an impact on treatment."
The human capital assessment of cost is important because "it puts a dollar value on the fact that many people die of cancer at a younger age," Yabroff said.
"But," Bradley added, "you can argue that people are worth more than the wages they earn."
The American Cancer Society has statistics on U.S. cancer deaths.
SOURCES: Cathy J. Bradley, Ph.D, professor, health administration, Virginia Commonwealth University, and Massey Cancer Center, Richmond; Robin Yaroff, Ph.D, epidemiologist, U.S. National Cancer Institute, Bethesda, Md.; Dec. 9, 2008, Journal of the National Cancer Institute, online
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