A landmark report released today by the Lance Armstrong Foundation (LAF) estimates the total economic burden of new cancer cases at $305 billion in 2009. The findings are included in the report, "Breakaway: The Global Burden of Cancer - Challenges and Opportunities," released today in Dublin at the premiere LIVESTRONG® Global Cancer Summit. The report provides a striking call-to-action for global communities to act and make new investments in cancer control, even in the face of the current economic downtown. Developed by the Economist Intelligence Unit and commissioned by LIVESTRONG with support from the American Cancer Society, the report is the first of its kind to detail the global cancer burden in economic terms.
"This report makes the powerful and staggering link between the well-understood human cost of cancer and the economic burden it places on countries around the world," said LAF President and CEO Doug Ulman. "It's a call to order that we must work collaboratively -- governments, NGOs, the development community and advocates -- to address the treatment expenditure gap and change the trajectory of this tidal wave of cancer. We have a choice -- invest now or pay later with significant government spending and loss of lives and productivity."
Commenting on the new report, Dr. Ala Alwan, Assistant Director-General, Noncommunicable Disease and Mental Health, World Health Organization, said, "These new data delineate a stark trajectory for cancer if immediate action is not taken. The rise of cancer creates an enormous burden on health systems around the world. But this is not just a health challenge; it undermines economic growth and acts as a chronic poverty trap for the poorest countries. Bilateral and multilateral donors are not responding to requests from developing countries to support them in building sustainable institutional capacities to address noncommunicable disease, because these issues are beyond those targeted by the Millennium Development Goals. We need to take a close look at addressing that gap."
Gaps in Treatment Funding and Geographic Distribution
The report also establishes a global treatment expenditure standard, based on estimated treatment costs in the country with the lowest case fatality rate for each site-specific cancer. The report projects a treatment expenditure gap of approximately $217 billion in 2009. Low and lower-middle income countries make up for 65 percent of that gap in investment. High-income countries representing 15 percent of the world population contribute to 94 percent of the global total expenditure, based on a relatively large share of cancer cases, medical spending per case and nearly all of the world's spending on cancer research.
In addition to the economic cost of cancer, the study compares projected new cancer diagnosis rates for 2009 with 2020. Assuming that every country's age pattern of new cancer cases remains stable, the new analysis undertaken for the report estimates that there will be 30 percent (3.9 million) more new cancer cases in 2020 than in 2009. The largest percentage increase in new cancer cases is projected to occur in Africa, with Asia having the most new cases in absolute terms.
While at one time cancer was widely believed to afflict only the elderly in affluent countries, the disease has moved beyond high-income countries and into the developing world. More new cases of cancer and more deaths from the disease occur today in the lower- and middle-income countries that make up the developing world than in high-income countries. Today, more than 50 percent of new cancer cases and nearly two-thirds of cancer deaths occur in the developing world. By comparison, in 1970, the developing world accounted for 15 percent of newly reported cancers.
"I call on Governments to commit to quantitative, time specific targets for improvements in cancer survival rates at a population level," said Professor David Hill, AO President of the International Union Against Cancer (UICC). "I want these targets to be aspirational, meaning they are attainable with additional efforts. The LIVESTRONG Global Cancer Summit is a great platform to get this message across."
Other key findings of the study include:
-- There will be an estimated 12.9 million new cancer cases globally in 2009 -- By 2020, the number of new cancer cases worldwide is anticipated to rise to 16.8 million -- By 2030, the number of new cancer cases is expected to rise to 27 million, with 17 million cancer deaths -- Cancers have already progressed to where they are incurable in 80 percent of patients in developing countries -- Evidence shows that only 5 percent of global resources for cancer are spent in the developing world. Low and lower-middle income countries will make up 46 percent of new cancer cases this year.
A Path Forward Through Unity
In conjunction with the release of the report, LIVESTRONG announced a statement of unity that provides a roadmap to reversing the course of the cancer epidemic and reducing the burden. The full text of the statement appears below:
In cancer, we face a looming public health crisis as cancer becomes the leading cause of death worldwide. Cancer strikes without respect for political borders, age or socioeconomic status and manifests differently from place to place. It is a global problem that requires collective action via a global movement to change the course of the disease in history. A failure to act is indefensible -- the human and economic costs are too high. And patients and survivors around the world cannot wait for action. From today forward, advocates, governments, the development community and the private sector must collaborate to realize new and effective policy, programmatic and investment solutions.
LIVESTRONG supports the following actions to make cancer a global priority:
1) Every government should develop and adopt a national cancer plan -- a coordinated strategy, goals and timeline for addressing the burden of the disease within their borders. Regional and supranational organizations should seek to coordinate efforts across borders.
2) Funding for cancer research, prevention and treatment should be prioritized as a public health investment that will yield significant future savings. Greater public and private investment is needed to close the gap between current spending and the significant burden of cancer borne by countries around the world.
3) Investments in essential public health infrastructure and education can have an impact on non-communicable and communicable diseases. We encourage the consideration of integrating non-communicable disease targets in the Millennium Development Goals to underscore the urgent need for governments, the international development community and philanthropic organizations to commit resources to meet the health needs of the world's population.
4) Cancer patients and survivors deserve to live, and die, with respect and dignity, not stigmatization because of their disease. Efforts to reduce stigma should be supported through the implementation of educational programs and awareness-building efforts, creation of support systems for patients and families and a health system that supports compassionate end-of-life care.
Components of the Economic Burden of Cancer
Medical costs include the costs of diagnosis, in-patient treatment and care, outpatient treatment and care and drugs; and make up 53 percent of the US$286 billion (worldwide cancer costs excluding research expenditures). Lost income due to cancer morbidity associated with new cancer cases makes up another 24 percent of the global 2009 total. The remainder is comprised of the costs of transportation to and from medical providers, the costs of alternative and homeopathic treatments and care, and the value of time associated with informal care-giving.
US$217 billion in medical and non-medical costs, US$19 billion for research and US$69 billion in lost productivity. In addition, we break new ground by determining how much spending would have to increase to achieve a global expenditure standard based on per case medical costs in the country with the lowest case fatality rate for each cancer investigated. The overall cost to achieve that global standard is US$217 billion.
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