🇬🇧 The economics of cancer screening and services

Abstract

Cancer is a major source of morbidity and mortality. It presents the highest economic burden in terms of cause-specific Disability-Adjusted Life Years (DALYs) of all human diseases and in 2020 accounted for nearly one in six deaths globally.
While the causes of cancer are multifactorial – and our understanding of them continues to evolve – it is estimated that around one third of deaths are related to life style factors that include tobacco and alcohol use, diet, low physical activity and high body mass index.
Advances in the prevention, earlier detection and treatment have contributed to major improvements in survival over time. As evidenced by the existence of differences in survival across countries and within countries by socio-economic status, the full potential of these advances have, however, yet to be fully realised. Moreover evidence that improvements have slowed in recent years presents a worrying trend.
Economics can provide valuable insights into individual life-style choices that influence engagement with primary prevention with implications for the cost and effectiveness of treatment. Economics can also provide valuable insights into clinical and policy decision making that set the broader context in which screening and treatment takes place.
Cancer registries are instrumental in providing real world evidence for economic analyses and have helped open new avenues of research on the role of pre-existing morbidities (and in particular cardio-vascular diseases) in cancer treatment and survival. Individual decisions around life style and screening can create path dependencies that constrain future clinical decisions around treatment. Understanding these relationships and the cost-benefit calculus that underpins them can help inform future cancer strategies, improve outcomes and reduce the cost of cancer for individuals and society.