Cancer costs billions a year in lost earnings

Texas alone loses $7 billion in productivity to deaths annually, as new study points to ‘staggering’ economic toll, urges preventative tactics

Cancer costs the nation $94 billion annually in lost productivity — including more than $7 billion in Texas — just from premature deaths, according to a new study that details the disease’s astounding economic toll nationally and by state.

The study, conducted by the American Cancer Society, found that the nation’s nearly half-million deaths caused by cancer in 2015 amounted to 8.7 million years of life lost. Those individual deaths cost an average of $191,000 each in lost earnings, the study said.

“This study provides important information for policymakers,” said Dr. Farhad Islami, scientific director for the cancer society and the study’s lead investigator. “It shows an investment in cancer prevention and early treatment isn’t just important for saving lives, it has a financial benefit.”

Islami said he was surprised at the high cost, given that the study only calculated lost earnings caused by death, not also those associated with treatment and missed work by people fighting the disease and loved ones caring for them. He noted that such costs would add significantly to the total.

Cancer is the nation’s secondleading cause of death, behind heart disease. The cancer society estimates it will cause nearly

607,000 deaths this year.

The study, which appears online Wednesday in the journal JAMA Oncology, is the first to look at lost productivity caused by cancer deaths at the state and national level.

The toll in Texas — more than 33,000 deaths and 617,000 years of life lost — was described as “staggering” by one leader state leader in the fight against cancer.

“There’s really no understating the impact,” said Michael Davis, chairman of the Cancer Alliance of Texas, a state group dedicated to reducing the impact of cancer. “And that’s just one year in one of the nation’s fastest growing states. So unless we take concerted efforts to stem the tide, the cancer burden in Texas will continue to increase.”

Still, Texas actually placed 28th among states, significantly better than other Southern states with which it frequently ranks at the bottom of many health surveys. Among regions, the South ranked at the bottom in this study.

The overall lowest lost earnings rate was Utah and the highest was Kentucky. Mississippi, West Virginia, Arkansas and Tennessee were the next highest. Islami and others attributed Utah’s strong showing to lower smoking and alcohol consumption tied to the state’s Mormon population.

In the study, Islami said that if all states had Utah’s lost earnings rate, the national loss would have been reduced by 29.3 percent or $27.7 billion. The years lost would have been reduced by 2.4 million.

Islami’s team estimated lost earnings by calculating years of life lost using numbers of cancer deaths and life expectancy data in individuals aged 16 to 84 who died from cancer in 2015, the latest year for which statistics are available.

The study found lung cancer cost the most in lost earnings — $21.3 billion, or 22.5 percent of the total. Next most costly were colorectal cancer ($9.4 billion, 10 percent); female breast cancer ($6.2 billion, 6.5 percent) and pancreatic cancer ($6.1 billion, 6.5 percent). The highest cost by age group was leukemia in ages 16 to 39 and lung cancer in ages 40 and over.

Texas’ numbers mirrored the national trend, but the state’s greatest outlier was liver cancer, known to occur at one of the nation’s highest rates. The study found lost productivity from its more than 2,000 liver cancer deaths in 2015 cost about $550 million in lost earnings, the fifth most in the nation.

The state’s high rate is linked to its sizable population of Hispanics, who health and government experts say have a genetic predisposition to liver disease.

The other cancer to cost Texas at a relatively high rate was cole-rectal cancer, which claimed more than 3,100 lives in 2015 and reduced earnings by about $805 million, the 17th highest. Islami noted that the state ranks low in colorectal cancer screening rates nationally.

Ray Perryman, a Waco-based economist who studies cancer’s cost in Texas, called the study “very well done” and “useful to those of us who analyze the detrimental economic effects of cancer on an ongoing basis.” One limitation: Because the study only measures death in a single year, he noted, it doesn’t allow analysis of trends.

Perryman’s work has found that the cost of cancer is generally rising in Texas, mostly due to the aging of baby boomers. He said new treatments and screening programs have had a positive impact.

It is unclear how much the state’s better-than-usual showing reflected prevention efforts by the Cancer Prevention and Research Institute of Texas, the state’s 10year-old $3 billion assault on the disease. Its taxpayer-funded money mostly goes toward research to develop and accelerate treatments to the marketplace, something that typically takes decades, but 10 percent of the $300 million allocated annually funds prevention and early detection efforts.

A CPRIT spokesman noted that Texas’ cancer death rate declined by 9 percent from 2010 to 2015. The national cancer death rate declined by 7.8 percent in that period.

Davis said the annual $30 million, while helpful, doesn’t come close to making up for the shortfall in the amount the Centers for Disease Control and Prevention recommend states spend on efforts to curb the use of tobacco, the No. 1 cause of preventable cancer deaths. In the 2020-21 budget passed last session, for instance, the Texas Legislature allocated $9.75 million each year for the state health department’s “reduce use of tobacco products” program, a far cry from than the $264 million the CDC calls for in Texas.

But Davis said he is encouraged that other legislative actions last session will have a positive impact — the new law that will boost the smoking age from 18 to 21; and the passage of a bill that will ask voters in November to approve a financing plan to extend CPRIT another 10 years.

Paul Scheet, MD Anderson Cancer Center’s epidemiology chair, added that the study provides “evidence of the need for the state to enact policies to support changes in behavior in Texans” — such as programs to expand vaccination against the human papillomavirus, the sexually transmitted infection that can lead to cancer; bills to limit tanning bed access; and anything that increases access to healthcare.

Previous research into cancer’s impact in Texas include a 2018 study by the Perryman Group that estimated the disease cost more than $104.6 billion in output losses per year and nearly 1.1 million lost jobs; and a 2001 Texas department of health study that estimated a cost of $14 billion a year. That estimate included $4.8 billion in direct medical costs and $9.1 billion in lost productivity.