Lung cancer is costliest cancer in European Union

By Joanna Lyford, Senior medwireNews Reporter

The total cost of cancer care across the European Union (EU) was an estimated € 126 billion (US$ 171.07 billion) in 2009, with lung cancer having the highest cost, at 15% of the total.

The findings come from a population-based cost-analysis, published in The Lancet Oncology, which also found very wide variation in cancer costs across the 27 individual EU countries.

The research was undertaken by Jose Leal (University of Oxford, UK) and colleagues, who adopted a societal perspective by including healthcare costs (primary care, emergency care, outpatient care, hospital inpatient care, drugs), informal care costs (losses incurred by relatives or friends to provide unpaid care), and productivity losses (lost earnings due to sick leave and early death).

These costs totaled € 126 billion (US$ 171.07 billion) in 2009, of which healthcare accounted for 40.5% (the bulk of which was inpatient care), informal care accounted for 18.5%, and productivity losses accounted for 41.0% (driven by premature mortality).

The researchers then looked at specific cancers, finding that the combined cost of lung, breast, colorectal, and prostate cancer was € 55.3 billion (US$ 75.25 billion) in 2009, or 44% of the total.

Of these four individual cancers, lung cancer had the highest cost, at € 18.8 billion (US$ 25.58 billion), equivalent to 15% of the total, followed by breast cancer (12%), colorectal cancer (10%), and prostate cancer (7%).

Lung cancer also had the highest productivity losses attributable to mortality and the highest costs of informal care, whereas morbidity losses were greatest for breast cancer.

Finally, the team examined costs in the individual countries of the EU, finding substantial variation. For instance, healthcare costs per citizen varied from € 16 (US$ 21.77) in Bulgaria to € 184 (US$ 250.37) in Luxembourg, with an overall average of € 102 (US$ 138.79).

Leal and co-authors conclude: “Our study draws attention to the need for cost-effective public health and screening measures to prevent cancer and improve early detection. Our results show wide differences between countries, the reasons for which are unclear and require further investigation.”

This variation is described as “staggering” and “intriguing” in an accompanying commentary, in which Gary Lyman (Duke University, Durham, North Carolina, USA) suggest that differences in inpatient care drive much of the disparity in cancer-related healthcare costs.

Lyman also observes that “robust data showing that increases in expenditure result in improved cancer outcomes remain elusive,” and that “cancer survival is more likely in the USA – where more is spent on healthcare per person than in any other nation – than in Europe.”

He writes: “[W]ell designed clinical trials complemented by high-quality real-world population data and clinically relevant modelling studies are needed to answer important questions about the true effect of health-care expenditures on meaningful clinical outcomes for the global community.”

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