State-by-state variations in cancer deaths suggest that effective cancer prevention and treatment could yield economic benefits.
A new study published in JAMA Oncology estimates that individuals between the ages of 16 and 84 who died of cancer in the United States in 2015 alone account for over $94 billion in lost earnings. This type of information offers policymakers another way of quantifying the burden of cancer, according to the study’s senior author, Robin Yabroff, Ph.D., senior scientific director of health services research with the American Cancer Society.
“Looking at the number of years that are lost due to premature cancer death gives you a different type of information than just looking at newly diagnosed patients—you’re really getting a sense of what would have happened in the absence of those deaths,” she told FierceHealthcare.
The study also took a more granular look at the data than most previous approaches, allowing researchers to estimate lost earnings both by type of cancer and at a state-by-state level. Lung cancer accounted for the greatest loss of wages at $21.3 billion, or 22.5% of all cases. Among the states, Utah’s $19.6 million in lost wages was the lowest in the country, while Kentucky had the highest losses of $35.3 million.
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The differences in lost wages from state to state surprised Yabroff. “I had known that there are differences in mortality rates by state—you do see higher cancer mortality rates in many southern states than you do in other states—but I really thought the magnitude of the differences between states, for example Utah to Kentucky or Mississippi, had really big differences in lost earnings.”
A variety of factors likely accounts for the difference in the economic impact of early cancer deaths from state to state, but that doesn’t mean states lack effective means to address the problem. In fact, many of the state-level policies that Yabroff recommends to address cancer risk factors, such as reducing smoking and countering obesity, offer additional benefits as they relate to population health beyond cancer treatment.
Connecting cancer to its economic consequences could also help policymakers better understand the relevance of existing policies that have demonstrated positive results. “There are a number of studies that we’ve conducted evaluating the effects of Medicaid expansion where we’ve found higher prevalence of screening, earlier diagnosis, and reductions in disparities in health insurance coverage,” Yabroff said.
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Using the current study’s data as a benchmark could also help to guide future policy decisions. However, Yabroff warns that there could be a gap between the implementation of new policies and a reduction in state-by-state disparities in economic impact because prevention, screening and treatment can take place long before a patient succumbs to cancer prematurely. In essence, that could mean the current disparities have yet to fully reflect state-level policies related to access to care and improved screening. For example, most of the states that have adopted Medicaid expansion did so in 2014 and 2015, so any potential improvement caused by cancer screening would likely show up in future studies.
And while Utah may have the lowest loss of wages relative to other states, Yabroff said it still has opportunities to reduce cancer risk factors by improving screening, access to care and treatment.
“We don’t know how to prevent all cancers, but there are some where we have a sense of what to do, like reducing smoking, improving physical activity and reducing obesity,” she said. “Those things are definitely associated with increased risk of cancer.”