Advancing Comparative Studies of Patterns of Care and Economic Outcomes in Cancer: Challenges and Opportunities

Cancer is a leading cause of morbidity and mortality worldwide (1). Cancer also accounts for a substantial proportion of health-care expenditures as well as productivity losses due to morbidity and premature death (2). Because incidence increases with age for most cancer sites (3,4), and populations are aging in most developed countries, prevalence is expected to increase appreciably in the future (2,5-8). Additionally, ongoing improvements in early detection and use of effective treatments are associated with improved survival following diagnosis, also increasing cancer prevalence. As a result of these trends, related medical expenditures (6) and costs associated with morbidity (9) and premature mortality (10,11) are expected to be even larger in the future. Moreover, health-care delivery trends, in particular the increasing use of expensive new chemotherapy drugs (12,13), are projected to be associated with increased costs of cancer care in the future. Measuring and projecting the economic burden associated with cancer and identifying effective policies for minimizing its impact are increasingly important issues for health-care policy makers and health-care systems at multiple levels.