Tackling the cancer burden: the economic impact of primary prevention policies
Cancer is a noncommunicable disease (NCD) with increasing incidence and therefore constitutes a major public health issue. To reduce the health and economic burden of cancer, policy-makers across the world have implemented a range of preventative interventions targeting risk factors with a known link to the disease.
In this article, the researchers examine the impact of six primary prevention interventions – related to physical inactivity, unhealthy diet or alcohol use – on cancer-related health outcomes and healthcare expenditure. They used the OECD Strategic Public Health Planning for NCDs (SPHeP-NCDs) model to quantify outcomes and costs for each intervention for years 2020–2050 across 37 countries.
Results from the model indicate that all interventions could lead to a reduction in the number of new cancer cases, in particular those targeting alcohol consumption.
Introducing an alcohol tax, for instance, is estimated to reduce related cancer cases by 5619 a year or 174,193 by 2050.
A breakdown of results by type of cancer revealed interventions had the largest impact on colorectal cancer with, on average, 41,140 cases avoided per intervention by 2050. In proportional terms, interventions had the greatest impact on new oesophageal and liver cancers.
Findings from this study are designed to assist decision-makers efficiently allocate limited resources to meet public health objectives.
More detailed study findings
At the individual country level, alcohol taxation has the greatest positive impact on the cancer burden in Austria, Czech Republic and Luxembourg with the proportion of new related cancer cases avoided for years 2020–2050 ranging between 0.51% and 0.55%.
Introducing Minimum Unit Pricing is expected to reduce new related cancer cases per year by 4554 or 141,175 by 2050. For MUP, the Czech Republic is estimated to experience the biggest gain with 0.51% of new cancer cases avoided followed by Austria and Ireland.
In proportional terms, interventions targeting alcohol pricing are estimated to have the largest effect on oesophageal and liver cancers. For example, over years 2020–2050, MUP is expected to reduce, on average across countries, 0.71% of new liver cancer cases with this figure increasing to 0.88% for oesophageal cancers.
Impact on cancer-related health costs
Each intervention results in health expenditure savings, albeit to differing extents.
A higher alcohol tax is associated with the greatest gain with each country, on average, saving US$0.50 per capita, per year in purchasing power parity (PPP) terms, which allows for accurate cross-country comparisons. For MUP, this figure is expected to decrease to USD PPP 0.42.
At the country level, the impact of alcohol pricing measures on health expenditure is estimated to be greatest in Luxembourg [per capita savings of USD PPP 1.34 and US$ PPP 1.65 per year for MUP and higher alcohol tax, respectively] and Norway [USD PPP 1.03 and USD PPP 1.26, respectively].
Scaling-up to the national level, for example, in Norway, translates into savings of US$ PPP 236 million from a higher alcohol tax and US$ PPP 193 million from MUP over years 2020–2050. Both Norway and Luxembourg are relatively small countries, in a larger country, such as Germany, savings from these two interventions increase to US$ PPP 2.42 billion and US$ 2.06 billion, respectively.