Every minute in the OECD, an estimated 11 people are diagnosed with cancer. This has far-reaching consequences for health systems, economies, and societies. According to OECD’s model-based estimates, cancer costs a total of EUR PPP 449 billion annually to OECD health systems, increasing health expenditure by 6% relative to a situation where there is no cancer. This is more than the total annual health budget of France. At the societal level, cancer effectively reduces the labour market by 3.1 million full-time workers through reduced productivity and hours worked, reducing workforce output by EUR PPP 163 billion per year – roughly equivalent to the annual gross domestic product (GDP) of Hungary (OECD, 2024[1]).
How can countries tackle the impact of cancer on health, the economy and society?
Note: These estimates are based on the OECD SPHeP NCDs model, predicting the burden of cancer over 2023‑50. Health expenditure estimates are calculated by comparing the baseline scenario to a hypothetical scenario in which there is no cancer, and therefore take into account the cost of other diseases as well as population dynamics.
Source: OECD SPHeP NCDs model, 2024.
Cancer costs are expected to grow in the future, for three main reasons.
1. Population ageing alone will lead to an increase in health spending on cancer, all other things being equal. Assuming that the incidence and survival rates of cancer per age group remains unchanged, per capita cancer health expenditure would grow by 67% between 2023 and 2050, on average across the OECD.
2. Efforts to improve cancer outcomes across countries would lead to higher spending on cancer as people survive for longer, require treatment for longer, and can get cancer again. Increasing survival rates to the levels of the best performing country will save many lives, but will add another 15% in treatment costs over the same period.
3. Higher treatment costs from new medicines and technologies, and additional costs associated with providing follow-up care for a growing number of cancer survivors, will further increase the total cost.
The percentage increase in per capita cancer health expenditure due to population ageing and improved cancer survival rates, in 2050 vs. 2023
Source: OECD SPHeP NCDs model, 2024. See https://stat.link/4cykpo.
Large variation in cancer outcomes across countries shows the significant scope to improve cancer care. Survival rates for lung cancer, for example, vary more than seven‑fold across EU and OECD countries. For colorectal cancer, the variation is more than two‑fold. OECD estimates suggest that, if all countries were to improve cancer screening, early diagnosis and timely, effective, affordable treatment to attain the best survival rates observed within the OECD and EU, a quarter of all premature deaths due to cancer would be prevented.
The impact of achieving the highest cancer survival rates observed across the OECD and EU on premature mortality (deaths in people aged under 75) due to cancer per 100 000 population; and as a percentage of total premature mortality due to cancer; per year, average over 2023‑50
Note: Digestive includes liver, oesophageal, pancreatic, and stomach cancer; head and neck includes lip and oral cavity, larynx, other pharynx, and nasopharynx cancer; and other includes prostate, cervical cancer and malignant skin melanoma.
Source: OECD SPHeP NCDs model, 2024. See https://stat.link/nvqyks.
To give patients the best chance for survival, regardless of where they live, countries should enhance cancer screening, early diagnosis, and access to effective treatment.
Screening is pivotal in the fight against certain cancers, yet significant disparities in screening rates persist both across and within countries. To boost uptake, countries should increase awareness and optimise the design of screening invitations and delivery.
Delays in getting access to care can be addressed by raising awareness of the early signs of cancer among patients, reducing diagnosis delays by informing healthcare workers, and improving referral processes from primary care to specialist oncology care to minimise treatment delays.
Finally, policy makers can enhance access to effective care at an affordable cost by promoting the use of generics and biosimilars, implementing collaborative Health Technology Assessments at a multinational level, improving the use of targeted treatments, and establishing Comprehensive Cancer Centres.
As around 40% of cancer cases can be prevented by healthier lifestyles, scaling up action to tackle tobacco and alcohol use, unhealthy diets, lack of physical activity and air pollution would significantly curb the growing burden of cancer.
International policy targets on cancer risk factors, such as those from the WHO Global Action Plan on non-communicable diseases, provide pointers that policy makers can follow. The analysis in this report shows that achieving the policy targets for six key cancer risk factors together could prevent around 8% of all cancer cases, 12% of premature deaths due to cancer, and lower the burden of cancer on health expenditure by 9%, between 2023 and 2050.
Cancer cases prevented (thousands and as a percentage of total number of cancer cases), premature cancer deaths avoided (thousands and as a percentage of total cancer premature mortality), and cancer health expenditure saved (EUR PPP billions and as a percentage of total burden of cancer on health expenditure) if policy targets on key cancer risk factors were achieved, total for OECD countries, per year, average over 2023‑50
Source: OECD SPHeP NCDs model, 2024. See https://stat.link/36fizb.
Tobacco remains the most important policy area for cancer prevention in the OECD, accounting for 40‑60% of the total impact of action on risk factors. If international policy targets on tobacco were achieved, 56 000 premature deaths would be prevented annually across OECD countries – one death every ten minutes – and EUR PPP 13.3 billion saved in cancer health expenditure. It is crucial that policy makers complement tobacco control policies with strategies that target a wider set of risk factors, including harmful alcohol use, diet, air pollution, overweight and physical inactivity.
Stronger action on risk factors has other societal benefits. For example, achieving the policy target on harmful alcohol use would also improve safety, preventing around 10% of premature deaths due to interpersonal violence and road traffic accidents, a total of 15 000 premature deaths per year across the OECD. A healthier diet would also reduce greenhouse gas emissions (see Box 1).
There are strong links between our diet and the environment. About one‑third of all anthropogenic (human-caused) greenhouse gas (GHG) emissions are linked our food system (Crippa et al., 2021[2]). This includes land-use, production (farming and harvesting), processing, transporting and distribution, packaging, cooking and disposing of waste. To reflect the relationship between diet and the environment, the OECD SPHeP NCDs model links the dietary factors to GHG emissions, using data from the WHO Diet Impact Assessment model (WHO, 2023[3]). Dietary targets were broadly based on national dietary guidelines with targets for sodium based on WHO-GAP target (WHO, 2013[4]; 2021[5]). Specifically, the targets focus on daily intakes of processed meat (<18g), red meat (<52g), whole grains (>80g), fruit (≥250g) and vegetables (≥250g), and a 30% reduction in intake of salt/sodium relative to 2010. For more information see Chapter 5 of the report.
If everyone in the OECD were to adhere to the diet policy targets, this is estimated to reduce GHG emissions by 304 Mt of carbon dioxide (CO2) equivalent per year (56 in the EU). This is the amount of GHG associated with more than 72 million gasoline‑powered passenger vehicles (13 million in the EU) (EPA, 2024[6]), or the number of cars in Germany and Spain combined.
As meat has one of the largest footprints when it comes to GHG emissions, countries with a higher baseline consumption of meat generally see a greater impact on per capita GHG emissions from meeting the diet policy targets (Figure 5). However, other factors also influence the relative impact: Argentina’s baseline consumption of meat is average, but a high proportion of meat consumption is beef (as opposed to pork or lamb, which have lower emission footprints). In addition, Argentina has relatively high emissions per kilo of beef due to local production inputs and methods. As a result, the per capita impact in Argentina is much higher than for other countries.
Change in per capita GHG emissions, kgCO2‑eq per year, average over 2023‑50
Note: Differences between countries are influenced by baseline consumption of target food groups, mix of animal products consumed, and the country-specific emission intensity of the food groups. In countries where meat, and in particular beef, consumption is low, the additional GHG emissions from increased fruit, vegetables and whole grain consumption can outweigh the reduction related to meat. In this case, GHG emissions can increase under the diet policy target. However, it is important to note that the scenario assumes no substitution, and that any increase in consumption is on top of current dietary intake. For whole grain, an increase in consumption is likely to come from substituting processed grain, rather than additional grain consumption to meet the whole grain target. In that case, the amount of raw product needed will not be substantially affected, and the impact on GHG emissions would in fact be minimal.
Source: OECD SPHeP NCDs model, 2024, and WHO (2023[3]) Diet Impact Assessment model. See https://stat.link/s8690n.
Note: This table aims to provide examples of different policies across risk factors, and is not exhaustive. Policies with an * are part of the WHO NCD Best Buys to tackle NCDs. However, this does not imply that the other policies are not cost-effective and feasible.
Vaccines are highly effective in preventing HPV infection and the associated cancers. But, while almost all OECD and EU countries have introduced HPV vaccination, coverage rates are generally low: the average coverage of girls receiving a first dose in the OECD was 69% in 2022, well below the target of 90%.
HPV vaccination programme coverage, first dose, females, in 2017 and 2022
Note: Averages for 2017 covers 20 EU countries and 31 OECD countries, while the 2022 average includes 22 EU and 34 OECD countries.
Source: WHO Immunisation Data (2024[7]), https://immunizationdata.who.int/global/wiise-detail-page/human-papillomavirus-(hpv)-vaccination-coverage?CODE=BGR&YEAR=. See https://stat.link/hycld0.
According to OECD estimates, optimal vaccination for HPV could prevent around 90% of all cervical cancer cases and premature deaths, reducing the total burden of cancer on health expenditure by 1.3% in OECD countries (not accounting for the cost of vaccination); and increasing workforce productivity and participation by the equivalent of EUR PPP 6.3 billion per year. Considering a single‑dose scheme, implementing catch-up vaccination where needed (e.g. after temporary disruption to the programme), and addressing misinformation could help countries increase uptake and coverage of HPV vaccination.
Impact of HPV vaccination on premature mortality (deaths in people aged under 75) due to cervical cancer, per 100 000 population and as a percentage of total premature mortality due to cervical cancer, per year, average over 2023‑50*
Note: *Estimates cover the period 2023‑50, but they assume optimal coverage and protection from cervical cancer from the beginning. In other words, they reflect the maximum potential impact of HPV vaccination, and not a scenario where optimal vaccine uptake is achieved over time, and where the protective effect against cervical cancer is observed down the line. For more information on the methodology, see Annex 6.A of Chapter 6.
Source: OECD SPHeP NCDs model, 2024, using inputs from the ATLAS model by IARC; Bonjour, M. et al., (2021[8]), “Global estimates of expected and preventable cervical cancers among girls born between 2005 and 2014: a birth cohort analysis”, https://doi.org/10.1016/S2468-2667(21)00046-3. See https://stat.link/u1je89.
References
[8] Bonjour, M. et al. (2021), “Global estimates of expected and preventable cervical cancers among girls born between 2005 and 2014: a birth cohort analysis”, The Lancet Public Health, Vol. 6/7, pp. e510-e521, https://doi.org/10.1016/S2468-2667(21)00046-3.
[2] Crippa, M. et al. (2021), “Food systems are responsible for a third of global anthropogenic GHG emissions”, Nature Food, Vol. 2/3, pp. 198-209, https://doi.org/10.1038/s43016-021-00225-9.
[6] EPA (2024), Greenhouse Gas Equivalencies Calculator, https://www.epa.gov/energy/greenhouse-gas-equivalencies-calculator#results (accessed on 6 May 2024).
[1] OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, OECD Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/85e7c3ba-en.
[9] WHO (2024), Immunization data, World Health Organization, https://app.powerbi.com/view?r=eyJrIjoiNDIxZTFkZGUtMDQ1Ny00MDZkLThiZDktYWFlYTdkOGU2NDcwIiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9 (accessed on 4 April 2024).
[7] WHO (2024), Immunization data, https://immunizationdata.who.int/global/wiise-detail-page/human-papillomavirus-(hpv)-vaccination-coverage?CODE=BGR&YEAR= (accessed on 4 April 2024).
[3] WHO (2023), Diet Impact Asessment model, World Health Organization, https://www.who.int/europe/publications/i/item/WHO-EURO-2023-8349-48121-71370.
[5] WHO (2021), Political declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases Mid-point evaluation of the implementation of the WHO global action plan for the prevention and control of noncommunicable diseases 2013–2020, World Health Organization, https://apps.who.int/gb/ebwha/pdf_files/WHA74/A74_10Add1-en.pdf.
[4] WHO (2013), Global action plan for the prevention and control of noncommunicable diseases 2013-2020, World Health Organization, https://iris.who.int/handle/10665/94384.
Read the full report:
OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, OECD Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/85e7c3ba-en.
Find out more about OECD’s work on public health:
Contact
OECD Public Health (✉ health.contact@oecd.org)
