The U.S. spends double the average of high-income countries on cancer care, but has only marginally ... [+]
The U.S. spends twice as much on cancer care than average for high-income countries but mortality rates are only slightly better than average for these countries, according to a new study.
“There is a common perception that the U.S. offers the most advanced cancer care in the world,” said Ryan Chow, an M.D./Ph.D. student at Yale and lead author of the study. “Our system is touted for developing new treatments and getting them to patients more quickly than other countries. We were curious whether the substantial U.S. investment on cancer care is indeed associated with better cancer outcomes,” added Chow.
The research was published recently in JAMA Health Forum and looked at how much money was spent on cancer care in 22 high-income countries, as well as their cancer mortality rates. The study found that the U.S. spends around $200 billion per year on cancer care, approximately $600 per person. The average of the 22 countries studied was just $300 per person, per year.
Despite this, the U.S. cancer mortality rates were just marginally better than the average for all of the countries studied. Six countries in the study had both lower cancer mortality rates and lower spending than the U.S; Finland, Iceland, Japan, Australia, South Korea and Switzerland.
“Countries that spend more on cancer care, do not necessarily have better cancer outcomes,” said Chow.
It is well known that tobacco smoking is a significant risk factor for cancer mortality with smokers having dramatically increased risk of developing a wide range of cancers, compared to non smokers. Many of these including lung cancer still have high mortality rates. In the U.S., smoking rates ar lower than many other countries, including some of those in the list of 22 high-income countries involved in the analysis, so the researchers assumed that this might have reduced cancer mortality rates. But when the researchers adjusted the data to take smoking rates into account, U.S. cancer mortality rates were still higher than nine countries in the analysis.
“Adjusting for smoking shows the United States in an even less favorable light, because the low smoking rates in the U.S. had been protective against cancer mortality,” said Chow.
The study authors suggest that drug pricing is one of the key factors contributing to the high cost of U.S. cancer care.
“Other countries and systems have much to teach the U.S. if we could be open to change,” said Elizabeth Bradley, PhD, co-author of the work and President and Professor of science, technology, and society at Vassar College in Poughkeepsie, NY. “The pattern of spending more and getting less is well-documented in the U.S. healthcare system; now we see it in cancer care, too,” Bradley added.
