Pearce Alison, Sharp Linda, Hanly Paul, Barchuk Anton, Bray Freddie, de Camargo Cancela Marianna, Gupta Prakash, Meheus Filip, Qiao You-Lin, Sitas Freddy, Wang Shao-Ming, Soerjomataram Isabelle
National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland; University of Technology Sydney, Building 5D, 1-59 Quay St, Sydney 2007, Australia.
Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, United Kingdom.
Cancer Epidemiol. 2018 Apr;53:27-34. doi: 10.1016/j.canep.2017.12.013. Epub 2018 Jan 30.
Over two-thirds of the world's cancer deaths occur in economically developing countries; however, the societal costs of cancer have rarely been assessed in these settings. Our aim was to estimate the value of productivity lost in 2012 due to cancer-related premature mortality in the major developing economies of Brazil, the Russian Federation, India, China and South Africa (BRICS).
We applied an incidence-based method using the human capital approach. We used annual adult cancer deaths from GLOBOCAN2012 to estimate the years of productive life lost between cancer death and pensionable age in each country, valued using national and international data for wages, and workforce statistics. Sensitivity analyses examined various methodological assumptions.
The total cost of lost productivity due to premature cancer mortality in the BRICS countries in 2012 was $46·3 billion, representing 0·33% of their combined gross domestic product. The largest total productivity loss was in China ($28 billion), while South Africa had the highest cost per cancer death ($101,000). Total productivity losses were greatest for lung cancer in Brazil, the Russian Federation and South Africa; liver cancer in China; and lip and oral cavity cancers in India.
Locally-tailored strategies are required to reduce the economic burden of cancer in developing economies. Focussing on tobacco control, vaccination programs and cancer screening, combined with access to adequate treatment, could yield significant gains for both public health and economic performance of the BRICS countries.
全球超过三分之二的癌症死亡发生在经济发展中国家；然而，这些国家中癌症的社会成本却很少得到评估。我们的目的是估计2012年巴西、俄罗斯联邦、印度、中国和南非（金砖国家）等主要发展中经济体因癌症相关过早死亡而损失的生产力价值。
我们采用基于发病率的方法，运用人力资本法。我们利用GLOBOCAN2012提供的年度成人癌症死亡数据，来估计每个国家癌症死亡与可领取养老金年龄之间损失的生产寿命年数，并使用国家和国际工资数据以及劳动力统计数据进行估值。敏感性分析检验了各种方法假设。
2012年金砖国家因癌症过早死亡导致的生产力损失总成本为463亿美元，占其国内生产总值总和的0.33%。生产力损失总额最大的是中国（280亿美元），而南非每例癌症死亡的成本最高（10.1万美元）。巴西、俄罗斯联邦和南非肺癌导致的生产力损失总额最大；中国是肝癌；印度是唇癌和口腔癌。
需要制定因地制宜的策略来减轻发展中经济体癌症的经济负担。关注烟草控制、疫苗接种计划和癌症筛查，再加上获得充分治疗，可能会给金砖国家的公共卫生和经济表现带来显著收益。
