Adult and Childhood Cancer
Following the methodology of Davis and Haugh (2005) and Landrigan et al. (2002), and using data from the National Heart Blood and Lung Institute (NHLBI), we estimate the environmentally attributable costs of adult and childhood cancer in Oregon.
Cost Estimates: The NHLBI estimated the direct and indirect cost of cancer in the U.S. in 2003 (NHLBI, 2003). According to this study, the costs for 2003 were expected to total $189.8 billion including $69.4 billion in direct health care costs (personal heath care expenditures for hospital and nursing home care, drugs, home care and physician and other professional services), $16.9 billion in indirect morbidity costs (lost productivity), and $103.5 billion in premature mortality costs.
This total of $189.9 billion in 2003 dollars is equivalent to $216.9 billion in 2007 dollars.
EAFR and Best Estimate: By some estimates, 75-80% of all cancer in the U.S. is in part due to broadly defined environmental factors including tobacco, diet, infectious agents, radiation, occupational exposure, and environmental contaminants (Davis & Muir, 1995). Two studies have estimated that exposure to environmental contaminants alone in air, water, and food are responsible for approximately 1-5% of all cancer mortality (Doll & Peto, 1981; Doll, 1998).
Following the methodology of Davies & Hauge (2005), this study uses a conservative best estimate of 5% and an EAFR for combined cancer morbidity and mortality of 2-10%.
Costs in Oregon
This estimate of the costs of cancer in Oregon attributable to environmental contaminants is based on the following assumptions:
- The NHLBI estimate is updated to $216.9 billion in 2007 dollars;
- The cancer costs in Oregon are 1.22% of the national costs (based on population); and
- A best estimate of 5% and an EAFR of 2-10%.
Based on these assumptions, the annual costs of cancer in Oregon is $2.6 billion in 2007 dollars.
Applying the EAFs of 0.02, 0.05, and 0.10 yielded the following results:
- EAF 0.02 = $52,400,000
- EAF 0.05 = $131,000,000
- EAF 0.10 = $262,000,000
Using these assumptions, the best estimate of the annual costs of cancer attributable to environmental contaminants in Oregon is $131 million in 2007 dollars (comprising $47.9 million in direct health care costs, $11.6 million in indirect morbidity costs, and $71.4 million in indirect premature mortality costs ), with a range of $52.4-262.0 million.
The environmentally attributable costs of adult and childhood cancer in Oregon are estimated at $131 million per year, with a range of $52.4 to $262 million.
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