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Dates: 2011-2012
Funding: The European Cancer Research Managers Forum, Pfizer
 Collaborators: Professor Richard Sullivan, King's College London
 Information: Jose Leal, Ramon Luengo-Fernandez

Results presented at 2012 Congress of the European Society for Medical Oncology
Vienna, Austria, 28 September 2012.

Results presented at 8th NCRI Cancer Conference, Liverpool, 7 November 2012. Abstract

Malignant neoplasms, more commonly known as cancer, are the second main cause of death after cardiovascular disease in Europe and are considered a major economic burden. Cancers cause 1.7 million deaths each year in Europe and over 1.2 million deaths in the European Union (EU) while being at the same time a major cause of years lost in early death. The main forms of malignant neoplasms in Europe, in terms of deaths and prevalence, are lung cancer, colon and rectum cancer, female breast cancer, and prostate cancer.

Cancers have an economic impact in the health care system, in family and friends who provide care for cancer patients, and on economic productivity because a large proportion of patients with cancer and the people who care for them would otherwise be in paid employment.

The aim of this study was to provide an estimate of the economic costs of cancers for all the 27 countries of the EU for the year 2009 by including direct health care costs, informal care costs, and productivity loss, and to estimate the proportion of cancer costs due to the four main forms of cancer, i.e. lung, colon and rectum, female breast, and prostate. The aim is to provide a potentially useful decision making aid for setting priorities in health care research.

For the purposes of the study malignant neoplasms were defined as all diseases in ICD-10 category C00-C97. In addition, we separately estimates costs associated with trachea, bronchus and lung cancer (ICD-10 codes C33-C34) (lung cancer), costs associated with colon and rectum cancer (ICD-10 codes C18-C21) (colorectal cancer), costs associated with breast cancer (ICD 10 code C50) (breast cancer), and costs associated with prostate cancer (ICD-10 code C61).

Total costs comprised healthcare costs, unpaid care costs by family and friends, lost earnings due to absence from work and premature death. The same methodological approach was used across all countries. Costs were estimated by identifying, from international and national sources, the annual volume of resources associated with each category within the most recent year for which data were available, regardless of the time of disease onset, and respective unit costs. We have employed a similar approach when estimating the economic burden of cardiovascular diseases and dementia in the EU and the UK. See CVD costs in Europe ( and Dementia in the EU (

Cancer cost the EU €126 billion in 2009, with health care accounting for €51.0 billion (40%). Across the EU, the health-care costs of cancer were equivalent to €102 per citizen, but varied substantially from €16 per person in Bulgaria to €184 per person in Luxembourg. Productivity losses because of early death cost €42.6 billion and lost working days €9.43 billion. Informal care cost €23.2 billion. Lung cancer had the highest economic cost (€18.8 billion, 15% of overall cancer costs), followed by breast cancer (€15.0 billion, 12%), colorectal cancer (€13.1 billion, 10%), and prostate cancer (€8.43 billion, 7%).