The burden of cancer in Japan, the United States, France, Germany, Italy, Spain, Sweden, and the United Kingdom.

Abstract

1569 Background: Cancer causes a significant burden to society in terms of human suffering and costs. We analyzed the burden of cancer in Japan, the US, France, Germany, Italy, Spain, Sweden and the UK. Methods: We reviewed the incidence, mortality and costs in Japan and compared with other countries. We also conducted survey of the actual economic burden of cancer patients in Japan. Results: The overall incidence in Japan is lower than other countries. Only in stomach cancer is the incidence in Japan higher. The incidence in Japan has been increasing in the past decades for the major cancers, except stomach cancer. Similar trends are found in the US and the European countries, although some countries show declining long trends in male lung cancer (US, Germany, Italy, Sweden and UK), colorectal cancer (US and Germany), breast cancer (US) and in prostate cancer (US). The overall cancer mortality and that of all the five major cancer types are increasing in Japan, but declining in other countries. The direct cost of cancer treatment in Japan amounts to US$23 billion. Indirect costs of morbidity and mortality amount to $65 billion. The cost of cancer per capita in Japan is $691, which is lower than in the US ($784) but higher than in France ($582) and in Sweden ($504). The annual out-of-pocket expenses are $11,000 on average in Japan (n=6,604). 7.3% of all health care resources are spent on cancer treatment In Japan, which is higher than in other countries. The expenditure on cancer drugs in Japan is $57 per capita, which is lower than in the US ($64) and France ($69), but higher than in the remaining countries. Conclusions: The trend in cancer mortality in Japan is, in contrast to the US and Europe, increasing. A more systematic use of economic evaluations of new cancer treatments in Japan would also support the use of the most cost effective alternatives. It is important to discuss the cost with patients and to minimize the economic burden of patients in clinical settings and in policy making.