Abstract
BackgroundMost measures of the cancer burden take a public health perspective. Cancer also has a significant economic impact on society. To assess this economic burden, we estimated years of potential productive life lost (YPPLL) and costs of lost productivity due to premature cancer-related mortality in Ireland.MethodsAll cancers combined and the 10 sites accounting for most deaths in men and in women were considered. To compute YPPLL, deaths in 5-year age-bands between 15 and 64 years were multiplied by average working-life expectancy. Valuation of costs, using the human capital approach, involved multiplying YPPLL by age-and-gender specific gross wages, and adjusting for unemployment and workforce participation. Sensitivity analyses were conducted around retirement age and wage growth, labour force participation, employment and discount rates, and to explore the impact of including household production and caring costs. Costs were expressed in €2009.ResultsTotal YPPLL was lower in men than women (men = 10,873; women = 12,119). Premature cancer-related mortality costs were higher in men (men: total cost = €332 million, cost/death = €290,172, cost/YPPLL = €30,558; women: total cost = €177 million, cost/death = €159,959, cost/YPPLL = €14,628). Lung cancer had the highest premature mortality cost (€84.0 million; 16.5% of total costs), followed by cancers of the colorectum (€49.6 million; 9.7%), breast (€49.4 million; 9.7%) and brain & CNS (€42.4 million: 8.3%). The total economic cost of premature cancer-related mortality in Ireland amounted to €509.5 million or 0.3% of gross domestic product. An increase of one year in the retirement age increased the total all-cancer premature mortality cost by 9.9% for men and 5.9% for women. The inclusion of household production and caring costs increased the total cost to €945.7 million.ConclusionLost productivity costs due to cancer-related premature mortality are significant. The higher premature mortality cost in males than females reflects higher wages and rates of workforce participation. Productivity costs provide an alternative perspective on the cancer burden on society and may inform cancer control policy decisions.
Highlights
Most measures of the cancer burden take a public health perspective
Estimation methods Numbers of deaths were converted into rates using population estimates from the Central Statistics Office, and standardised using the World Standard Population to provide World Age Standardised Rates (WASR; http:// www-dep.iarc.fr/WHOdb/glossary.htm)
World age-standardised mortality rates (WASRs) and years of potential productive life lost (YPPLL) by gender Table 1 presents the number of deaths in people of all ages, WASRs and YPPLL for all cancers and by site, for males and females
Summary
Cancer has a significant economic impact on society To assess this economic burden, we estimated years of potential productive life lost (YPPLL) and costs of lost productivity due to premature cancer-related mortality in Ireland. A few studies have estimated the costs of lost productivity, but these have generally considered individual cancer sites (e.g. skin [5], breast [6], pancreas [7]). While providing a useful insight into the proportion of economic costs related to individual cancers, they fail to yield an estimate of the overall burden of cancer-related premature mortality on the economy. A very limited number of studies of productivity loss in multiple cancer sites exist, mainly from North America [8,9] and Asia [10]; estimates from Ireland are absent and those from European countries generally are limited
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