The Burden of Cancer: Individual and Societal Outcomes

Abstract

It is paramount that an accurate assessment of the impact of a cancer diagnosis is available with which to plan future resource allocation and to highlight the area to direct future policy initiatives. In the second chapter I take a modelling approach to estimate the economic burden of bladder cancer due occupational exposure. Using a multi-stage Markov model, I estimate direct, indirect, and intangible lifetime costs of bladder cancer starting in the year 2011. The results of this analysis indicate that there is a substantial economic burden associated with occupational bladder cancer. Of the three components that make up the total economic costs, intangible costs represent the largest proportion, followed by indirect and direct costs. In the third chapter, I use a data set created via a linkage of several administrative data resources to estimate the relationship between cancer diagnosis and annual labour market earnings. Using the Mahalanobis' distance and propensity score matching combined with a difference-in-difference regression, I isolate the impact of cancer diagnosis on labour market earnings of cancer survivors by comparison to their peers without cancer. There are two conclusions that can be derived from the results. First, I found that cancer survivors recover a fraction of their labour market earnings over time as they are further removed from the time of the cancer diagnosis. Secondly, I found the heterogeneous effects of cancer where most cancer survivors showed a persistent loss of labour market earnings except breast, cervix, and skin cancer survivors in the less-active age group. In the fourth chapter I examine the impact of cancer on health using three commonly used health indicators: life expectancy, Health Utility Index, and health-adjusted life expectancy. Specifically, I decomposed the differences between individuals with and without cancer in above-mentioned indicators by age and cancer type—considering all cancer types, then specifically breast, colorectal and prostate cancers. The results of the study indicate the heterogeneous effects of cancer on health outcomes and provide a repository of health outcome information that other researchers and policymakers can use.