While the U.S. spends twice as much on cancer care as the average high-income country, its cancer mortality rates are only slightly better than average, according to a new analysis by researchers at Yale University and Vassar College.
The results were published on May 27 at the JAMA Health Forum.
There is a common perception that the United States offers the most advanced cancer care in the world. Our system is promoted to develop new treatments and get them to patients faster than other countries. We were curious as to whether substantial U.S. investment in cancer care is actually associated with better cancer outcomes. “
Ryan Chow, lead author, MD / Ph.D. Yale University student
Of the 22 high-income countries included in the study, the United States had the highest spending rate.
“The U.S. spends more than $ 200 billion a year on cancer care, about $ 600 per person, compared to an average of $ 300 per person in other high-income countries,” said lead author Cary Gross. professor of medicine and director of the National Clinical Fellowship Program at Yale. “This raises the key question: are we getting our money’s worth?”
The researchers found that national spending on cancer care had nothing to do with population-based cancer mortality rates. “In other words, countries that spend more on cancer care don’t necessarily have better cancer outcomes,” Chow said.
In fact, six countries -; Australia, Finland, Iceland, Japan, Korea and Switzerland -; it had lower cancer mortality and lower spending than the United States.
Smoking is the strongest risk factor for cancer mortality, and smoking rates have historically been lower in the United States than in other countries. When researchers monitored international variations in smoking rates, U.S. cancer mortality rates did not differ from the average high-income country, with nine countries; Australia, Finland, Iceland, Japan, Korea, Luxembourg, Norway, Spain and Switzerland -; with lower smoking-adjusted cancer mortality than in the United States.
“The smoking adjustment shows the United States in an even less favorable light, because low smoking rates in the U.S. had protected against cancer mortality,” Chow said.
More research is needed to identify specific policy interventions that could significantly reform the U.S. cancer care system, the authors say. However, they point to lax regulation of cancer drug approval and drug prices as two key factors contributing to the high cost of cancer care in the United States.
“The pattern of spending more and earning less is well documented in the U.S. health care system; now we see it in cancer care,” said co-author Elizabeth Bradley, president of Vassar College and a professor of science, technology and society. . “Other countries and systems have a lot to teach in the US if we could be open to change.”
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Magazine reference:
Chow, RD, et al. (2022) Comparison of cancer-related spending and mortality rates in the U.S. versus 21 high-income countries. JAMA Health Forum. doi.org/10.1001/jamahealthforum.2022.1229.