In cancer, prevention is better and cheaper than cure
Approximately 15.5 million Americans have a history of cancer, with an estimated 1,688,780 new cases and 609,640 deaths annually. With 87% of diagnoses occurring in persons 50 years of age, cancer remains the second leading cause of death in the United States. Cancer's financial burden is often substantial during treatment phases and often worsens with improving prognoses. Cancer's direct medical costs in the United States exceed $80 billion and indirect costs of premature morbidity and mortality exceed $130 billion. With 6.5% of direct costs among non-elderly persons alone involving out-of-pocket payments, over half of all persons with cancer experienced house repossession, bankruptcy, loss of independence, and relationship breakdowns.
The costs associated with cancer recurrence remain high. Lack of health insurance and other barriers prevents many Americans from receiving optimal cancer prevention, early detection, and treatment. According to the US Census Bureau, 28.5 million Americans (9%) were uninsured during the entire 2017 calendar year, down more than 13 million from 2013 because of the implementation in January 2014 of several new provisions of the Affordable Care Act (ACA). The largest increase in health insurance coverage was among those with the lowest education and income. Hispanics and blacks continue to be the most likely to be uninsured, 16% and 11%, respectively, compared to 6% of non-Hispanic whites.
Statistics produced by cancer Research UK, has shown that There are around 363,000 new cancer cases in the UK every year, that's more than 990 every day (2014-2016). In females in the UK, there were around 178,000 new cancer cases in 2016. In males in the UK, there were around 185,000 new cancer cases in 2016. Since the early 1990s, incidence rates for all cancers combined have increased by more than a tenth (12%) in the UK. Rates in females have increased by almost a sixth (16%), and rates in males increased by less than a twentieth (2%). Incidence rates for all cancers combined are projected to rise by 2% in the UK between 2014 and 2035, to 742 cases per 100,000 people by 2035. UK incidence is ranked higher than two-thirds of Europe and higher than 90% of the world.
Regardless of the region, 40%-85% of cancer patients stop working during initial treatment, with absences ranging up to 6 months. Deductibles and co-payments for treatment, supportive care, and non-medical or indirect costs (i.e. travel, caregiver time, and lost productivity) may be financially devastating even with healthcare coverage.
Experts are now talking about "financial toxicity" to refer to the unintended financial consequences of medical treatment, including both objective and subjective attributes reflecting a patient's financial burden.
As large financial burdens have been found to adversely affect access to care and outcomes among cancer patients, the active development of approaches to mitigate these effects among already vulnerable groups remains of key importance.
Death or Debt? National Estimates of Financial Toxicity in Persons with Newly Diagnosed Cancer. Am Journalisms Med. October 2018 Volume 131, Issue 10, Pages 11871199.e5. DOI: https://doi.org/10.1016/j.amjmed.2018.05.020
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