Comparison of Cancer-Related Spending and Mortality Rates in the US vs 21 High-Income Countries.

Area of Science:

• Health economics
• Oncology
• Comparative effectiveness research

Background:

• Previous studies indicated US cancer care costs were justified by superior outcomes compared to European nations before 2011.
• Contemporary value assessment of US cancer care against other high-income countries remains unclear.

Purpose of the Study:

• To determine if cancer mortality rates in 2020 were lower in countries with higher cancer-related spending.
• To estimate the incremental cost per averted cancer death across high-income countries.

Main Methods:

• Cross-sectional analysis of national-level data from 22 high-income countries in 2020.
• Assessed association between cancer care expenditures and age-standardized cancer mortality rates, with and without smoking adjustment.
• Calculated US incremental costs per averted cancer death relative to peer nations.

Main Results:

• The US spent $584 per capita on cancer care, more than double the median of $296.
• US cancer mortality rate (86.3 per 100,000) was higher than 6 other countries.
• Cancer care expenditures showed no association with cancer mortality rates across countries (R = -0.05).
• The US spent between $1 million and over $5 million per averted cancer death compared to other countries.

Conclusions:

• US cancer mortality rates were not lower than the median despite spending twice the median amount on cancer care.
• Findings suggest US cancer care expenditure may not align with improved population health outcomes.
• Further research is needed to understand the value of cancer care spending in high-income countries.