GDP impact of Cancer and Cardiovascular Disease

Goals

1. Introduction - disease, risk factors, and impact
2. Global Health Impact
3. USA Health Impact
3. Projections
5. Economic and Productive Impact in USA and Globally
5. Mortality Projections amongst Cancer and CVD patients

Early Findings

Introduction: Non-communicable diseases such as Cardiovascular disease (CVD) and Cancer are the first and second leading causes of death in the United States and globally.[1,2] Both are diseases with shared risk factors and are linked to disability, poor quality of life, and significantly contributes to chronic morbidity and mortality.

Cancer:


Global Health Impact:
There were an estimated 18 million cancer cases around the world in 2018, of these 9.5 million cases were in men and 8.5 million in women. More than one in ten cancer patients do not die from their cancer but from heart and blood vessel problems instead, according to new research published in the European Heart Journal. For some cancers, like breast, prostate, endometrial, and thyroid cancer, around half will die from cardiovascular disease (CVD).[2]
USA Health Impact:
In 2017, there were an estimated 15,760,939 people living with cancer of any site in the United States. In 2018, 9.6 million death were attributed to cancer. According to WHO, globally about 1 in 6 death is due to cancer. The Surveillance, Epidemiology and End Results (SEER) study is one of the largest and most comprehensive research, funded by the National Cancer Institute (USA) that provides information on cancer statistics in an effort to reduce the cancer burden among the U.S. population.[4] The study included deaths from CVD, which included heart disease, high blood pressure, cerebrovascular disease, blocked arteries and damage to the aorta – the main artery carrying blood from the heart to the rest of the body. They adjusted their analyses to take account of factors that could affect the results, such as age, race and sex, and they looked specifically at 28 different types of cancer. Among the 3,234,256 cancer patients, 38% (1,228,328) died from cancer and 11% (365,689) died from CVDs. Among the deaths from CVD, 76% were due to heart disease, and the risk of dying from CVD was highest in the first year after a cancer diagnosis and among patients younger than 35 years. In the USA, the relative five-year survival rate for cancer patients is approximately 67.4% (2010-2016).[4]
Projections: Approximately 39.5 percent of men and women will be diagnosed with cancer of any site at some point during their lifetime, based on 2015–2017 SEER model projections.[4]
USA Economic Impact: The Agency for Healthcare Research and Quality (AHRQ) estimates that the direct medical costs (total of all health care costs) for cancer in the US in 2015 were $80.2 billion. More than 1.6 million people are diagnosed with cancer, and almost 600,000 die from it, making it the second leading cause of death.[6] The cost of cancer care continues to rise and is expected to reach almost $174 billion by 2020. Lack of health insurance and other barriers to health care prevent many Americans from getting optimal health care. According to the US Census Bureau, about 28 million people (9%) in the US were uninsured in 2016.[6] According to Cancer Facts & Figures 2018, “Uninsured patients and those from many ethnic minority groups are substantially more likely to be diagnosed with cancer at a later stage, when treatment can be more extensive, costlier, and less successful.”[6]
Impact on Productivity: The annual productivity cost from cancer mortality in the base model was approximately $115.8 billion in 2000; the projected value was $147.6 billion for 2020. Death from lung cancer accounted for more than 27% of productivity costs. A 1% annual reduction in lung, colorectal, breast, leukemia, pancreatic, and brain cancer mortality lowered productivity costs by $814 million per year. Including imputed earnings lost due to caregiving and household activity increased the base model total productivity cost to $232.4 billion in 2000 and to $308 billion in 2020.

Cardiovascular Disease:


Global Health Impact: Cardiovascular diseases (CVDs) are the foremost cause of global mortality, contributing to an estimated 17.9 million lives each year. CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions. Four out of five CVD deaths are due to heart attacks and strokes, and one third of these deaths occur prematurely in people under 70 years of age. Raised blood pressure is the leading risk factor for cardiovascular disease. The global prevalence of raised blood pressure (defined as systolic and/or diastolic blood pressure more than or equal to 140/90 mmHg) in adults aged 18 years and over was around 24.1% in men and 20.1% in women in 2015. The number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with the increase largely in low- and middle-income countries.
USA Health Impact: According to the CDC, one person dies every 37 seconds in the United States from CVD. About 647,000 Americans die from heart disease each year—that’s 1 in every 4 deaths. Mortality estimates from Heart disease is higher in males (24.4%) compared to females (22.3%).
USA Economic Impact: In a study conducted between 2-14-2015, it was reported that the Heart diseases costs the United States about $219 billion annually. This includes the cost of health care services, medicines, and lost productivity due to death.
Impact on Productivity: More than 859,000 Americans die of heart disease or stroke every year—that’s one-third of all deaths. These diseases contribute to a significant economic toll, while costing the American health care system $199 billion per year, and causing $131 billion in lost productivity on the job.
Prevention Strategy: Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies. Individuals with cardiovascular disease or who are at high cardiovascular risk (due to the presence of one or more risk factors such as hypertension, diabetes, hyperlipidaemia or already established disease) need early detection and management using counselling and medicines, as appropriate.

Mortality Projections amongst Cancer and CVD patients:
It is predicted that from 1969 through 2020, the number of heart disease deaths would decrease 21.3% among men (–73.9% risk, 17.9% growth, 34.7% aging) and 13.4% among women (–73.3% risk, 17.1% growth, 42.8% aging) while the number of cancer deaths would increase 91.1% among men (–33.5% risk, 45.6% growth, 79.0% aging) and 101.1% among women (–23.8% risk, 48.8% growth, 76.0% aging). [1] It is also predicted that cancer would become the leading cause of death around 2016, although sex-specific crossover years varied. [1]


References:
1. Weir HK, Anderson RN, King SM, Soman A, Thompson TD, Hong Y, Moller B, Leadbetter S. Peer reviewed: heart disease and cancer deaths—trends and projections in the United States, 1969–2020. Preventing chronic disease. 2016;13.
2. World Health Organization, Fact Sheets, Cardiovascular Disease. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
3. World Health Organization, Fact Sheets, Cancer. https://www.who.int/news-room/fact-sheets/detail/cancer
4. https://seer.cancer.gov/statfacts/html/all.html
5. https://progressreport.cancer.gov/after/economic_burden#field_most_recent_estimates
6. https://www.cancer.org/cancer/cancer-basics/economic-impact-of-cancer.html#:~:text=Cancer%20is%20the%20second%20most,and%20death%20due%20to%20cancer.

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