ABSTRACT
BACKGROUND: Incidence of cancer in Saudi Arabia has increased for the last two decades, ratcheting up to global levels. Yet, there is a dearth of research on the burden of lung cancer. This study examined the association between new cases of lung cancer and factors such as gender, age, and year of diagnosis; and forecast new cases and extrapolated future economic burden to 2030. METHODS: This a national-level cohort study that utilized the Saudi Cancer Registry data from 1999 to 2013. Multivariate regression was used; new lung cancer cases forecast and economic burden extrapolated to 20130. Sensitivity analysis was conducted to assess the impact of a range of epidemiologic and economic factors on the economic burden. RESULTS: Of the 166,497 new cancer cases (1999-2013), 3.8% was lung cancer. Males and Saudis had over threefold higher cases compared with females and non-Saudis, respectively. While the age group ≥65 years had 1.14 times or 14% increase in new cases, under-30 years had 97.2% fewer cases compared with age group 45-59. Compared with 1999, the period 2011-2013 had a 106% average increase. The years 2002-2010 registered an average 50% rise in new cases compared to 1999. New cases would rise to 1058 in 2030, an upsurge of 87% from 2013. The future economic burden was estimated at $2.49 billion in 2015 value, of which $520 million was attributable to care management and $1.97 billion in lost productivity. The economic burden for the period 2015-2030 will be $50.16 billion. The present value of this burden in 2015 values will be $34.60 billion, of which 21% will be attributable to care management. Estimates were robust to uncertainty, but the aged-standardized rate and 5-year survival rate would account for much of the variability compared with the economic factors. CONCLUSION: Findings reveal an upsurge of lung cancer burden in incidence and potential economic burden, which may inform cancer control measures.
ABSTRACT
BACKGROUND: Cancer incidence in Saudi Arabia has increased for the last two decades, ratcheting up to global levels. The study aimed to analyze cancer trends and the contributions of various cancer types, forecast incidence, and estimate the economic burden in 2030. METHODS: A national-level cohort study utilizing the Data of Cancer Registry of patients who were diagnosed in 1999-2015. New cases in 2016-2030 were forecast and predicted based on 1999-2015 data. We used growth assumption and regression analysis to predict the trends of cancer cases. We assessed the contributions of cancer types to incidence trends. We carried forecasting of new cases and extrapolation of the potential economic burden. We conducted a sensitivity analysis of the cost of cancer with respect to changes in economic and epidemiologic factors. RESULTS: The findings suggest that the number of known cancer cases increased by 136% from 1999 to 2015 and is projected to rise by 63% in 2030. The forecast indicates female cases will account for higher number of cases and greater proportion increase. The future cost of all cancer types would be estimated at $7.91 billion in 2015 value, of which $3.76 billion will be attributable to care management and $4.15 billion in lost productivity. With the assumption of growth of the aged-standardized incidence rate, the costs of care management and lost productivity are projected to be $5.85 and $6.47 billion, respectively in 2030, an increase of 56% in each component. The future undiscounted total estimated economic burden for the period 2015-2030 would be $159.44 billion, of which 47.5% will be attributable to care management. Estimates were robust to uncertainty, but the 5-year prevalence of cancer survivorship would account for the greatest variability. CONCLUSION: Our model showed an upsurge of cancer burden in terms of incidence and the potential economic burden, which may inform cancer control measures.