MedicalResearch.com Interview with:
Farhad Islami, MD PhD
Scientific Director, Surveillance Research
American Cancer Society, Inc
MedicalResearch.com: What is the background for this study?
Response: In the United States, cancer is the second leading cause of death, and premature cancer deaths impose significant economic burden. Contemporary information on the economic burden of cancer mortality can inform policies and help prioritize resources for cancer prevention and control, but this information is lacking.
In our study, we provide contemporary estimates for the loss of future earnings (lost earnings) due to cancer death at national and state levels for all cancers combined and for major cancers.
MedicalResearch.com: What are the main findings?
Response: The total lost earnings due to premature cancer death in ages 16-84 years in the United States in 2015 was $94.4 billion, associated with more than 8.7 million years of life lost. The highest lost earnings were for lung cancer ($21.3 billion), followed by cancers of the colorectum ($9.4 billion), female breast ($6.2 billion), and pancreas ($6.1 billion). By state, total lost earnings ranged from $139 million in Wyoming to $9,512 million in California. To provide comparable results across states, we calculated age-standardized lost earning rates, which showed considerable variation, with the rate in Kentucky 80% higher than in Utah ($35.3 million vs. $19.6 million per 100,000 population). States with the highest overall age-standardized lost earning rates were in the South, followed by the Midwest. We also estimated that 29.3% of total lost earning that occurred in 2015 ($27.7 billion out of $94.4 billion) would have been avoided if all states had the same age-specific lost earning rates as Utah, the state with the lowest age-standardized lost earning rate; this proportion ranged from 13.6% in Colorado to 47.3% in Kentucky.
MedicalResearch.com: What should readers take away from your report?
Response: Overall, our findings indicate that preventing premature cancer deaths would have substantial economic benefit nationally and for all states, as lost earnings from these deaths in the United States is substantial.
How can reductions in lost earnings due to deaths from cancer be achieved?
Previous research has shown that about half of all cancer deaths in the United States are attributable to potentially modifiable risk factors (thus, potentially avoidable), and that delivery of effective screening and treatment could prevent a number of premature cancer deaths. Indeed, we found that although exposure to modifiable risk factors, cancer screening, and high-quality treatment can be further improved in Utah, even achieving Utah’s age-specific lost earning rates by other states could reduce lost earnings from cancer deaths by 29.3% nationally and by as much as 47.3% in Kentucky. Thus, implementation of comprehensive cancer prevention interventions (e.g., tobacco control) and equitable access to high-quality care (e.g., through increasing health insurance coverage options) across all states could reduce the burden of cancer and associated disparities. Health care providers can contribute to achieving this goal as they have a central role in the delivery of cancer prevention, screening, and treatment.
MedicalResearch.com: Is there anything else you would like to add?
Response: We used a human capital approach which values years of life lost more for individuals with higher incomes and placed no value on years of life lost for individuals not in the workforce. This approach mainly estimates the impact of cancer deaths on the economy. Furthermore, we likely underestimated productivity loss because we did not consider lost earnings from lower performance or absenteeism, informal caregiving, and cancer deaths in ages <16 and ≥85 years because of data limitations.
Disclosures: The authors report being employed by the American Cancer Society, which received a grant from Merck Inc. for intramural research outside the submitted work; however, their salary is solely funded through the American Cancer Society. No other disclosures were reported.
Islami F, Miller KD, Siegel RL, et al. National and State Estimates of Lost Earnings From Cancer Deaths in the United States. JAMA Oncol. Published online July 03, 2019. doi:10.1001/jamaoncol.2019.1460
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