FINDINGS of a study recently published in the Journal of Cancer Epidemiology have revealed that the cost per death ratio in India was a startling 2.73; almost double than that of other BRICS countries. India has also recorded a total productivity loss of $ 6.7 billion in 2012 due to cancer, representing 0.36 per cent of the GDP; second only to South Africa that recorded $1.9 billion amounting to 0.49 per cent of its GDP, found the study.
The study was conducted as part of the European Short Term Scientific Mission to assess the loss of productivity in BRICS countries,
While the cost per death of productivity lost in India was just under $20,000 — the lowest of the BRICS countries — the greatest total productivity losses in the country — $0.74 billion from lip and oral cancers — is alarming. China, too, recorded an annual loss of nearly $8 billion in productivity due to tobacco smoking.
Dr Pankaj Chaturvedi, cancer surgeon at the Tata Memorial Hospital, said, “The use of smokeless tobacco, often combined with betel quid, can be attributed to almost 50 per cent of oral cavity cancers in India. Lip and oral cancers dominate lost productivity in India due to the relatively high prevalence of chewing tobacco.”
Gender disparity in lifestyle factors, like smoking tobacco, also revealed pronounced results in loss of productivity. Smoking prevalence among men and women was found to be 23 per cent and 2 per cent, respectively, in India.
Dr P Gupta, director of Healis-Sekhsaria Institute for Public Health, Navi Mumbai, and co-author of the paper, said, “The different patterns of workforce participation by gender in BRICS countries serve to exacerbate the gender disparity in productivity losses. In India, impact of increasing female workforce participation on estimates of lost productivity, overlooks the fact that women in India have significant household and community roles, as well as completing unpaid work in family business or agricultural work, which, when lost due to cancer, still represents a loss to society.”
The study revealed that the loss of productivity in BRICS economies due to cancer-related premature mortality is considerable in total cost terms — $46.3 billion — which represents 0.33 per cent of the combined GDP. In contrast to developed countries, it added, many of the cancers that result in high loss of productivity in the BRICS countries are amenable to prevention, early detection or treatment. Till date, screening programmes have been difficult to implement in almost all developing countries due to a lack of infrastructure and resources. Differences in the availability of, and access to, adequate treatments causes variability in survival and resulting productivity losses in both developed and developing countries.
“In India and China, the lost productivity costs per death of leukemia are relatively high (5 per cent of the total), perhaps because advanced, multi-modality treatments can be difficult to access. The costs and logistical difficulties in implementing screening and treatment programmes highlight the importance of prevention in relation to cancer in the BRICS countries” added Gupta.
Chaturvedi said, “This research reaffirms that affirmative policies promoting lifestyle changes that reduce the burden of cancer would have positive effects on Indian economy rather than destabilise it as claimed by tobacco/areca nut/fast food/ Sugary drinks lobby. A combination of tobacco control, alcohol control, vaccination programs and cancer screening would lead to significant gains for both health as well as economics of India.”