Quantifying Cancer Productivity Losses in Europe: Economic Impact Analysis

Cancer productivity losses from premature mortality and morbidity due to leading cancers across 28 European countries in 2022 totaled €39.8 billion, as estimated via the human capital approach in this study. Key findings reveal that tracheal, bronchus, and lung cancer, alongside colon and rectum, breast, pancreatic, and prostate cancers, drove 899,581 deaths, 17.3 million years of life lost (YLL), 896,510 years of productive life lost (YPLL), and €30.7 billion in present value of future lost productivity (PVFLP). For morbidity, breast, prostate, colon and rectum, tracheal/bronchus/lung cancers, and non-Hodgkin lymphoma generated 993,648 YLD, 210,400 productive YLD (PYLD), and €9.1 billion in value of YLD (VYLD), underscoring cancer’s dual mortality and disability burdens.

Lung Cancer’s Mortality Dominance

Tracheal, bronchus, and lung cancer emerged as the primary driver of mortality-related cancer productivity losses, accounting for 37.2% of the 899,581 deaths (334,247 cases), 40.7% of YLL (7.0 million years), 41.5% of YPLL (372,112 years), and 43.7% of PVFLP (€13.4 billion), with an average PVFLP per death of €40,160. Breast cancer, despite fewer deaths (122,277 or 13.6%), inflicted the highest per-death impact at €49,411 PVFLP and 1.69 YPLL per death, reflecting its disproportionate effect on working-age individuals (23.1% of YPLL). These patterns highlight how cancer types with earlier onset in productive years amplify economic costs, as evidenced by consistent rankings across deaths, YLL, and PVFLP, transitioning seamlessly into morbidity where overlaps like breast and lung cancers persist.

Breast Cancer’s Morbidity Lead

Breast cancer dominated morbidity outcomes, contributing 31.3% of YLD (310,952 years), 40.9% of PYLD (85,958 years), and 35.5% of VYLD (€3.2 billion), far exceeding other types like colon and rectum cancer (21.6% PYLD). The top five morbidity cancers collectively yielded €9.1 billion VYLD from 210,400 PYLD, with rankings shifting for productive metrics—colon/rectum rising to second—due to adjustments for labor force participation and unemployment. Country-level data reinforced these trends, with Germany, France, and the UK driving the bulk (e.g., Germany’s YLD at 185,253), while per-death and per-case metrics exposed disparities, such as Romania’s high YLL per death (22.74 years). Sensitivity analyses confirmed retirement age as the paramount driver, followed by wages and labor participation, validating the robustness of these estimates.

Human Capital Model Details

The human capital model was used to compute YPLL, PVFLP, PYLD, and VYLD, drawing years of life lost (YLL) and years lived with disability (YLD) from the Institute for Health Metrics and Evaluation (IHME) Global Burden of Disease (GBD) 2022 database for five top mortality (tracheal/bronchus/lung, colon/rectum, breast, pancreatic, prostate) and five top morbidity (breast, prostate, colon/rectum, tracheal/bronchus/lung, non-Hodgkin lymphoma) cancers across 28 countries. Inputs included country-, sex-, and age-specific (15-69 years) data on deaths, retirement age, wages, labor force participation, and unemployment from World Bank and Eurostat sources, with a 3% discount rate for PVFLP and no discounting for VYLD. Calculations aggregated country-level results, assuming uniform intra-age-group distributions and one YLD equating to one lost work year, enabling precise valuation of productivity restricted to working ages. Deterministic sensitivity analyses (±10% variations) further supported claims by identifying retirement age’s outsized influence.

Policy Push to Cut Losses

These findings emphasize indirect costs’ €39.8 billion total (PVFLP + VYLD) that rival prior estimates like €70 billion in 2018 productivity losses. Substantial inter-country variations—e.g., Switzerland’s €68,245 PVFLP per death from high wages versus Bulgaria’s €9,855, and Eastern Europe’s elevated per-death YLL—mirror access inequities, aligning with EU Beating Cancer Plan goals for prevention (e.g., tobacco control), screening expansion, and timely treatment to curb disparities. Quantifying morbidity via VYLD fills literature gaps, may inform policy priorities by highlighting breast cancer’s dual burden and supporting prioritized reimbursement for early interventions that preserve workforce productivity. This would ultimately foster equitable resource allocation amid rising cancer incidence.