More people than ever before are surviving cancer, but it's coming at a price - one expected to grow to $158 billion a year in the U.S. by the next decade. The National Cancer Institute (NCI) said the number of survivors is expected to increase from 13.8 million over the next 10 years to 18.1 million, and associated costs of care will rise significantly.
Based on growth and aging of the U.S. population, the new study projected that medical expenditures for cancer in the year 2020 will reach at least $158 billion – an increase of 27 percent over 2010. If newly developed tools for cancer diagnosis, treatment and follow-up continue to be more expensive, medical expenditures for cancer could reach as high as $207 billion.
These new projections are higher than previously published estimates of direct cancer expenditures, largely because the researchers used the most recent data available – including Medicare claims data through 2006. These include payments for newer, more expensive, targeted therapies which attack specific cancer cells and often have fewer side effects than other types of cancer treatments.
An example of this would be the adoption of new treatment for Chronic Myelogenous Leukemia (also known as Chronic Myelocytic Leukemia) with the use of targeted drug therapies known as tyrosine kinase inhibitors in 2001. The drug, provided in tablet form, is taken by patients from diagnosis until the end of life. The annual cost of the drug alone is currently from $60,000 to $90,000.
The report is based on the most recent data available on cancer incidence, survival, and costs of care. In 2010, medical costs associated with cancer were projected to reach $124.6 billion, with the highest costs associated with breast cancer ($16.5 billion), followed by colorectal cancer ($14 billion), lymphoma ($12 billion), lung cancer ($12 billion) and prostate cancer ($12 billion).
If cancer incidence and survival rates and costs remain stable and the U.S. population ages at the rate predicted by the U.S. Census Bureau, direct cancer care expenditures would reach $158 billion in 2020, the report said.
To project national cancer expenditures, the researchers combined cancer prevalence, which is the current number of people living with cancer, with average annual costs of care by age (less than 65 or 65 and older). According to their prevalence estimates, there were 13.8 million cancer survivors alive in 2010, 58 percent of whom were age 65 or older.
If cancer incidence and survival rates remain stable, the number of cancer survivors in 2020 will increase by 31 percent, to about 18.1 million. Because of the aging of the U.S. population, the researchers expect the largest increase in cancer survivors over the next 10 years to be among Americans age 65 and older.
To develop cost projections, the authors used average medical costs for the different phases of cancer care: the first year after diagnosis, the last year of life, and the time in between. For all types of cancer, per-person costs of care were highest in the final year of life.
Per-person costs associated with the first year after a cancer diagnosis were more varied, with cancers of the brain, pancreas, ovaries, esophagus and stomach having the highest initial costs and melanoma, prostate and breast cancers having the lowest initial-year costs.
Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, and Brown ML. Projections of the Cost of Cancer Care in the United States: 2010-2020. Jan 19, 2011, JNCI, Vol. 103, No. 2.
National Cancer Institute: Cancer Prevalence and Cost of Care Projections:
National Cancer Institute: Targeted Drug Therapies Fact Sheet