According to a new study released by World Health Organization's (WHO) International Agency for Research on Cancer (IARC), billions of US dollars are lost in productivity in major emerging economies15, due to premature mortality owing to cancer.

Led by the International Agency for Research on Cancer (IARC) in partnership with leading cancer research institutions in these countries, the study shows that the productivity loss in Brazil, the Russian Federation, India, China, and South Africa, collectively known as the BRICS countries, reached $46.3 billion in 2012. This represents 0"33% of their combined GDP, with country-specific proportions of GDP ranging from 0"21% in Brazil to 0"49% in South Africa16.

The BRICS countries account for more than 40% of the world's population, 25% of the global gross domestic product (GDP), and 42% of the world's cancer deaths. Although they have diverse levels of wealth, and health indicators, the BRICS countries have all undergone particularly rapid demographic and economic growth. They are affected by infection-related cancers as well as cancers associated with changing lifestyles (changes in diet, lack of physical activity, obesity, reproductive patterns etc.). Yet each of these countries has a distinct cancer profile, and therefore, a tailored approach to national cancer control policy is required.

Economic impact of major cancers in BRICS countries

The aim of this study was to estimate – for the first time – the value of productivity lost due to cancer-related premature mortality in Brazil, the Russian Federation, India, China, and South Africa (collectively known as the BRICS countries) in 2012.

Figure 1 (below) shows country wise Economic Loss productivity wise due to premature Cancer Mortality in the BRICS region

Figure 1

Across all the BRICS countries, liver cancer and lung cancer have the largest impact on total productivity lost. In the BRICS countries, combined together, liver ($8"8 billion), lung ($8"0 billion), stomach ($4"7 billion), oesophagus ($2"7 billion), and colorectal cancer ($2"5 billion) contributed the greatest lost productivity.

Among males, total productivity loss was highest for liver ($8"2 billion), lung ($7"1 billion), stomach ($4"1 billion), oesophagus ($2"5 billion), and colorectal ($1"9 billion) cancers. Among females, total productivity loss was highest for breast ($2"1 billion), cervix ($1"5 billion), lung ($0"9 billion), stomach ($0"7 billion), and liver ($0"7 billion) cancers.

The largest total productivity loss ($28 billion) was in China, which is particularly affected by liver cancer. Infection with hepatitis B virus and dietary exposure to aflatoxins are major contributors to this productivity loss.

In the Russian Federation, the considerable contribution of liver cancer and head and neck cancers to overall premature cancer mortality was probably associated with high consumption of alcohol.

The impact of tobacco smoking on lung cancer mortality was also observed in South Africa and Brazil. Despite successful tobacco control policies, such as those implemented in Brazil, tobacco remains a significant risk factor in these countries and rising tobacco-related productivity losses are expected in future. In India, the use of chewing tobacco was a leading cause of economic loss due to premature mortality from cancers of the lip and oral cavity.

Other lifestyle-related risk factors were also shown to have an effect on the cancer burden, such as rapidly increasing rates of obesity in Brazil.

The study further highlighted the potential economic benefits that could be accrued from introducing, or increasing coverage of, vaccinations for hepatitis B (HBV, for the prevention of liver cancer), human papilloma virus (HPV, for the prevention of cervical and ano-genital cancers), and Helicobacter pylori (for the prevention of stomach cancer). Vaccination for HBV and HPV is clearly cost-effective (based on developed country thresholds), but remains beyond the reach of many low income countries without additional funding or implementation support.

Conclusion:

This research, for the first time, provides the estimates of lost productivity related to premature cancer-related mortality in the BRICS economies. The results show that these costs are significant − $46"3 billion, representing 0"33% of the combined GDP of BRICS countries. The markedly different patterns of cancer burden measured as lost productivity across the BRICS countries highlight the need for local cancer control priorities and strategies.

Footnotes

15 http://www.iarc.fr/en/media-centre/pr/2018/pdfs/pr255_E.pdf

16 https://doi.org/10.1016/j.canep.2017.12.013

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