title: Economic burden of cancer across the European Union: a population-based cost analysis.
abstract: BACKGROUND
  In 2008, 2·45 million people were diagnosed with cancer and 1·23 million died because of cancer in the 27 countries of the European Union (EU). We aimed to estimate the economic burden of cancer in the EU.
  
  
  METHODS
  In a population-based cost analysis, we evaluated the cost of all cancers and also those associated with breast, colorectal, lung, and prostate cancers. We obtained country-specific aggregate data for morbidity, mortality, and health-care resource use from international and national sources. We estimated health-care costs from expenditure on care in the primary, outpatient, emergency, and inpatient settings, and also drugs. Additionally, we estimated the costs of unpaid care provided by relatives or friends of patients (ie, informal care), lost earnings after premature death, and costs associated with individuals who temporarily or permanently left employment because of illness.
  
  
  RESULTS
  Cancer cost the EU €126 billion in 2009, with health care accounting for €51·0 billion (40%). Across the EU, the health-care costs of cancer were equivalent to €102 per citizen, but varied substantially from €16 per person in Bulgaria to €184 per person in Luxembourg. Productivity losses because of early death cost €42·6 billion and lost working days €9·43 billion. Informal care cost €23·2 billion. Lung cancer had the highest economic cost (€18·8 billion, 15% of overall cancer costs), followed by breast cancer (€15·0 billion, 12%), colorectal cancer (€13·1 billion, 10%), and prostate cancer (€8·43 billion, 7%).
  
  
  CONCLUSIONS
  Our results show wide differences between countries, the reasons for which need further investigation. These data contribute to public health and policy intelligence, which is required to deliver affordable cancer care systems and inform effective public research funds allocation.
authors.affiliation: Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
authors.forename: Ramon
authors.initials: R
authors.lastname: Luengo-Fernandez
authors.forename: Jose
authors.initials: J
authors.lastname: Leal
authors.forename: Alastair
authors.initials: A
authors.lastname: Gray
authors.forename: Richard
authors.initials: R
authors.lastname: Sullivan
mesh_terms: D000553:Ambulatory Care / Q000191:economics; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use; D016527:Drug Costs; D004636:Emergency Service, Hospital / Q000191:economics; D005060:Europe / Q000453:epidemiology; D005062:European Union / Q000191:economics*; D059066:Gross Domestic Product; D017048:Health Care Costs; D005102:Health Expenditures; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008495:Medical Oncology / Q000191:economics*; D018803:Models, Economic; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D011320:Primary Health Care / Q000191:economics; D012044:Regression Analysis; D012111:Residence Characteristics; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents