Cancer costs SE Asia socially, economically

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The rising prevalence of cancer will become an overwhelming burden on society and healthcare systems across Southeast Asia if immediate action is not taken, a new study by the George Institute for Global Health shows.

Released in Indonesia on Thursday, the results of the study conducted in Indonesia, Vietnam, Malaysia, Thailand, Myanmar, the Philippines, Cambodia and Laos suggested that aging populations and the rising cancer burden were leading to a risk of cancer becoming an epidemic that could devastate the region.

The ASEAN Costs in Oncology (ACTION) study, which was conducted between 2012 and 2014, examined the cost of cancer treatment for 9,513 patients in the eight countries. It aimed at assessing the impact of cancer on household economic wellbeing, patient survival and quality of life.

It revealed that of the 9,513 cancer patients, after 12 months, 48 percent experienced financial catastrophe and 29 percent had passed away. Financial catastrophe is defined as having to spend 30 percent or more of household income on out-of-pocket expenses for cancer treatment.

Additionally, 44 percent of the patients who survived experienced economic hardship as a consequence of their cancer, of which a majority ended up using their life savings.

“The cost of cancer does not only affect patients, but also their families and society as a whole,” said Mark Woodward, professor of biostatistics from the George Institute for Global Health.

The ACTION study also provided evidence for the countries to put in place policies to improve access to cancer care, and provide adequate financial protection from the burden of costs of the illness.

“We hope the evidence from the ACTION study will help governments of countries in Southeast Asia to develop strategies and policies for combating cancer for [the] long term,” Woodward said.

With the growing burden of all cancers in the region, urgent action is needed to protect populations from the financial burden of the disease and to reduce the impact of the loss of economic productivity.

There is also an urgent need to create and better utilize existing social safety nets to protect citizens from poverty and economic hardship after cancer diagnosis, particularly in socioeconomically disadvantaged communities.

“When we look at the data, we can see that the costs associated with non-communicable diseases, such as cancer, are a significant driver of poverty in the region. By creating and utilizing social safety nets, governments can prevent their citizens from poverty and economic hardship after being diagnosed with cancer,” Woodward highlighted. He hoped that with the results and findings of the study, governments would be able to formulate strategies to control cancer and maintain the productivity of their people and economies.

Nirmala Bhoo-Pathy, cancer epidemiologist at the University of Malaya, shared an example that on average, the cost of treatment for breast cancer — the most common cancer found in the study — could reach up to US$15,000 per year.

“[For] patients, whose income was $1,100 a month or lower, [it] would be very difficult to pay for their treatment. With average GDP [gross domestic product] per capita in 2014 for the eight countries being $3,553.75, most cancer patients had to use money from their savings and experienced financial catastrophe in maintaining their quality of life,” she stated.

Data from the study showed that nearly 88 percent of the cancer patients were diagnosed with stage two to stage four cancer, whereas only 12 percent of them were diagnosed at the first stage.

It is also estimated that there were more than 770,000 new cases of cancer and 527,000 cancer deaths in the region in 2012. By 2030, the number of new cases is expected to rise about 70 percent to reach 1.3 million.

Nirmala highlighted that to combat cancer effectively, the countries would need to implement a national cancer-control program within their existing health systems, especially by improving early detection.

“If we want to prioritize our action, early detection is the most appropriate one that will give the most impact in controlling cancer,” she said.

In Indonesia, the ACTION study began in 2012 involving 12 major hospitals to monitor 2,335 cancer patients — a quarter of the total number of patients involved in the study.

University of Indonesia public health policy lecturer Hasbullah Thabrany acknowledged that cancer control had not been prioritized by the Indonesian government.

However, he appreciated that in line with recommendations from the ACTION study, the Indonesian government had implemented early cancer detection programs at local health clinics and primary health-care service providers, while last year the government launched a universal healthcare coverage program.

“This has helped to open access to healthcare services for patients, and is a good start toward taking care of cancer patients,” Hasbullah said.

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