Beyond the human body, the debilitating nature of cancer is also being felt across the global economy. A rapidly ageing world population is seeing greater incidences of cancer among the elderly and the socioeconomic repercussions are vast.
Countries are shoring up cancer treatment services, placing a huge strain on existing healthcare systems. Rising morbidity and premature mortality levels also threaten to undo economic progress by negatively impacting gross domestic product (GDP) and national productivity levels.
While most countries have existing protocols in place to mitigate the intersection of cancer and ageing, more needs to be done. Key solutions include providing better training and education for practitioners in geriatric oncology and increasing the representation of the elderly in clinical trials.
These were key findings from the KPMG–Sanofi 2022 When Cancer Grows Old report, which highlights the economic, healthcare and financial implications of an ageing world population that is seeing an uptick in cancer diagnoses.
Conducted from May 2021 to January 2022, the research quantifies the estimated socioeconomic cost of cancer among the elderly in the United Kingdom, United States, China and parts of Europe by modelling the growth in cancer incidence and developing burden projections to the year 2040. This is done by analysing demographic and medical trends.
Cancer and the silver tsunami
Research has found that the elderly (people aged 65 and above) are 11 times more likely to develop cancer as compared to younger people. As seen in the graph below, the elderly account for a disproportionately higher share (56.3%) of total cancer incidence in the world.
As a result of cancer, the years of life lost or lived with disability can result in opportunity costs such as income. In the long run, this trend can have a severe impact on a country’s GDP and national productivity levels.
The total economic impact from the Disability-Adjusted Life Years (DALYs) — which measures overall disease burden based on the number of years lost due to ill-health, disability or early death — in China, and EU4 (France, Germany, Spain, Italy) and UK and US were 1-2% of their respective GDPs in 2020. This is expected to rise to ~3% by 2040, resulting in significant economic losses.
Cancer incidence in the world by age groups, 2019
Caregiver burden by cancer types and region over 2 years
Key issues facing cancer treatment for the elderly
1. Insufficient use of geriatric assessments
Despite the proven efficiency of geriatric assessments in reducing cancer treatment side effects and minimising falls among elderly cancer patients, this mode of care is still underused. Only 17% out of 332 cancer practitioners surveyed in the United States carried out geriatric assessments on their patients in 2019.
2. Lack of geriatric training among oncologists
While the number of elderly patients with cancer is on the rise, the number of oncologists trained in geriatric medicine remains low. A study of oncology trainees in the UK found that 66.1% reported never receiving training on the needs of older people with cancer, while 19.4% reported to have received this training only once.
3. Disproportionately low number of older patients in clinical trials
Older patients are also being underrepresented at the clinical trial level. This means that evidence and knowledge about how elderly patients respond to specific medications and treatments remains inadequate. As a result, this hinders the overall cancer treatment process for the elderly. The report shows that the proportion of people aged 70 and above who enrolled in FDA clinical trials (2005–2015) is disproportionate to cancer incidence in that age group.
Read KPMG's summary of the cancer burden in each of the three regions below: