Tackling the Impact of Cancer on Health, the Economy and Society

Cancer continues to be one of the most pressing public health challenges, with far-reaching consequences for health systems, economies, and societies. Every minute in the OECD, an estimated 11 people are diagnosed with cancer. According to OECD’s model-based estimates, cancer costs a total of EUR PPP 449 billion annually to OECD health systems, increasing health expenditure by 6% relative to a situation where there is no cancer. This is more than the total annual health budget of France. At the societal level, cancer lowers labour market outputs through reduced productivity and hours worked, reducing workforce output by EUR PPP 163 billion per year – roughly equivalent to the annual gross domestic product (GDP) of Hungary.

Large variation in cancer outcomes across countries shows the significant scope to improve cancer care. Survival rates for lung cancer, for example, vary more than seven‑fold across EU and OECD countries. For colorectal cancer, the variation is more than two‑fold. OECD estimates suggest that, if all countries were to improve cancer screening, early diagnosis and timely, effective, affordable treatment to attain the best survival rates observed within the OECD and EU, a quarter of all premature deaths due to cancer would be prevented.

Cancer costs are expected to grow in the future, for three main reasons. First, population ageing alone will lead to an increase in health spending on cancer, all other things being equal. Assuming that the incidence and survival rates of cancer per age group remains unchanged, per capita cancer health expenditure would grow by 67% between 2023 and 2050, on average across the OECD. Second, efforts to improve cancer outcomes across countries would lead to higher spending on cancer as people survive for longer, require treatment for longer, and can get cancer again. Increasing survival rates to the levels of the best performing country will save many lives, but will add another 15% in treatment costs over the same period. Third, higher treatment costs from new medicines and technologies, and additional costs associated with providing follow-up care for a growing number of cancer survivors, will further increase the total cost.

To give patients the best chance for survival, regardless of where they live, countries should enhance cancer screening, early diagnosis, and access to effective treatment. Screening is pivotal in the fight against certain cancers, yet significant disparities in screening rates persist both across and within countries. To boost uptake, countries should increase awareness and optimise the design of screening invitations and delivery. Delays in getting access to care can be addressed by raising awareness of the early signs of cancer among patients, reducing diagnosis delays by informing healthcare workers, and improving referral processes from primary care to specialist oncology care to minimise treatment delays. Finally, policy makers can enhance access to effective care at an affordable cost by promoting the use of generics and biosimilars, implementing collaborative Health Technology Assessments at a multinational level, improving the use of targeted treatments, and establishing Comprehensive Cancer Centres.

As around 40% of cancer cases can be prevented by healthier lifestyles, scaling up action to tackle tobacco and alcohol use, unhealthy diets, lack of physical activity and air pollution would significantly curb the growing burden of cancer.

International policy targets on cancer risk factors, such as those from the WHO Global Action Plan on non-communicable diseases, provide pointers that policy makers can follow. The analysis in this report shows that achieving the policy targets for six key cancer risk factors together could prevent around 8% of all cancer cases, 12% of premature deaths due to cancer, and lower the burden of cancer on health expenditure by 9%, between 2023 and 2050.

Tobacco remains the most important policy area for cancer prevention in the OECD, accounting for 40‑60% of the total impact of action on risk factors. If international policy targets on tobacco were achieved, 56 000 premature deaths would be prevented annually across OECD countries – one death every ten minutes – and EUR PPP 13.3 billion saved in cancer health expenditure. It is crucial that policy makers complement tobacco control policies with strategies that target a wider set of risk factors, including harmful alcohol use, diet, air pollution, overweight and physical inactivity.

Stronger action on risk factors has other societal benefits. For example, achieving the policy target on harmful alcohol use would also improve safety, preventing around 10% of premature deaths due to interpersonal violence and road traffic accidents, a total of 15 000 premature deaths per year across the OECD. A healthier diet would also reduce greenhouse gas emissions by 304 Mt per year – the equivalent of taking all the cars in Germany and Spain off the road.

Vaccines are highly effective in preventing HPV infection and the associated cancers. But, while almost all OECD and EU countries have introduced HPV vaccination, coverage rates are generally low: the average coverage of girls receiving a first dose in the OECD was 69% in 2022, well below the target of 90%. According to OECD estimates, optimal vaccination for HPV could prevent around 90% of all cervical cancer cases and premature deaths, reducing the total burden of cancer on health expenditure by 1.3% in OECD countries (not accounting for the cost of vaccination); and increasing workforce productivity and participation by the equivalent of EUR PPP 6.3 billion per year. Considering a single‑dose scheme, implementing catch-up vaccination where needed (e.g. after temporary disruption to the programme), and addressing misinformation could help countries increase uptake and coverage of HPV vaccination.