Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
JAMA Oncol. 2023 Apr 1;9(4):465-472. doi: 10.1001/jamaoncol.2022.7826.
IMPORTANCE: Cancers are a leading cause of mortality, accounting for nearly 10 million annual deaths worldwide, or 1 in 6 deaths. Cancers also negatively affect countries' economic growth. However, the global economic cost of cancers and its worldwide distribution have yet to be studied. OBJECTIVE: To estimate and project the economic cost of 29 cancers in 204 countries and territories. DESIGN, SETTING, AND PARTICIPANTS: A decision analytical model that incorporates economic feedback in assessing health outcomes associated with the labor force and investment. A macroeconomic model was used to account for (1) the association of cancer-related mortality and morbidity with labor supply; (2) age-sex-specific differences in education, experience, and labor market participation of those who are affected by cancers; and (3) the diversion of cancer treatment expenses from savings and investments. Data were collected on April 25, 2022. MAIN OUTCOMES AND MEASURES: Economic cost of 29 cancers across countries and territories. Costs are presented in international dollars at constant 2017 prices. RESULTS: The estimated global economic cost of cancers from 2020 to 2050 is $25.2 trillion in international dollars (at constant 2017 prices), equivalent to an annual tax of 0.55% on global gross domestic product. The 5 cancers with the highest economic costs are tracheal, bronchus, and lung cancer (15.4%); colon and rectum cancer (10.9%); breast cancer (7.7%); liver cancer (6.5%); and leukemia (6.3%). China and the US face the largest economic costs of cancers in absolute terms, accounting for 24.1% and 20.8% of the total global burden, respectively. Although 75.1% of cancer deaths occur in low- and middle-income countries, their share of the economic cost of cancers is lower at 49.5%. The relative contribution of treatment costs to the total economic cost of cancers is greater in high-income countries than in low-income countries. CONCLUSIONS AND RELEVANCE: In this decision analytical modeling study, the macroeconomic cost of cancers was found to be substantial and distributed heterogeneously across cancer types, countries, and world regions. The findings suggest that global efforts to curb the ongoing burden of cancers are warranted.
重要性：癌症是导致死亡的主要原因之一，占全球每年近 1000 万人死亡，即每 6 人死亡就有 1 人死于癌症。癌症也对各国的经济增长产生负面影响。然而，癌症的全球经济成本及其在全球的分布尚未得到研究。 目的：估计和预测 204 个国家和地区 29 种癌症的经济成本。 设计、设置和参与者：一种决策分析模型，该模型在评估与劳动力和投资相关的健康结果时纳入经济反馈。使用宏观经济模型来解释：（1）癌症相关死亡率和发病率与劳动力供应的关系；（2）受癌症影响的人的教育、经验和劳动力市场参与的年龄性别特定差异；（3）癌症治疗费用从储蓄和投资中转移的情况。数据于 2022 年 4 月 25 日收集。 主要结果和测量指标：国家和地区的 29 种癌症的经济成本。成本以 2017 年不变价格的国际美元表示。 结果：从 2020 年到 2050 年，全球癌症的估计经济成本为 25.2 万亿美元（以 2017 年不变价格计算），相当于全球国内生产总值的 0.55%的年税。经济成本最高的 5 种癌症是气管、支气管和肺癌（15.4%）；结肠癌和直肠癌（10.9%）；乳腺癌（7.7%）；肝癌（6.5%）；和白血病（6.3%）。中国和美国在癌症方面面临的经济成本绝对值最大，分别占全球总负担的 24.1%和 20.8%。尽管 75.1%的癌症死亡发生在低收入和中等收入国家，但它们在癌症经济成本中的份额较低，为 49.5%。高收入国家治疗费用对癌症总经济成本的贡献大于低收入国家。 结论和相关性：在这项决策分析模型研究中，发现癌症的宏观经济成本很大，并且在癌症类型、国家和世界区域之间分布不均。研究结果表明，全球遏制癌症持续负担的努力是合理的。
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