The negative consequences of the global economic crisis may include an increase in the number of cancers in the countries of the OECD, scientists have said. More unemployment and less public-health spending on healthcare could be partly to blame.
The study, published in The Lancet, investigates how economic woes in the OECD impacted all-cancer mortality.
While unemployment appeared to increase the number of cancer-related deaths, the team shows that countries offering universal health coverage fared better than those who did not.
Expenses and unemployment
The research is based on a longitudinal analysis using data from the World Bank and WHO, collected between 1990 and 2010 and including over two billion people.
Several cancers were included in the analysis - prostate cancer in men, breast cancer in women, colorectal and lung cancer in men and women.
Controlling for country-specific demographics and infrastructures, the researchers find that in total, the 2008-10 crisis can be associated to about 260 000 excess cancer-related deaths in the OECD. This relationship is even more significant when it comes to treatable cancers. Based on 2000-2007 trends, the team identified an excess of 40 000 deaths from 2008 to 2010 linked to treatable cancers alone.
Two factors - unemployment and healthcare expenditure - seem to explain these trends. Unemployment rises were significantly associated with an increase in all-cancer mortality, as the devastating consequences of being jobless may have taken a toll on individuals' well-being.
How much public authorities spent on healthcare also impacted the rate of cancer mortality, with higher spending linked to lower number of deaths. Additionally, countries with universal health coverage, like France, appeared to be better protected.
A fatal combination
Lack of job and healthcare coverage therefore proved a fatal combination, reducing people's access to care, as well as the likelihood of recovering from an otherwise treatable cancer.
"Countries without universal health coverage, access to health care can often be provided via an employment package," explains co-author Professor Rifat Atun, from Harvard University. "Without employment, patients may be diagnosed late, and face poor or delayed treatment."
The study does include a number of limitations: it only shows an association between mortality, unemployment and public-sector spending, and cannot prove cause and effect. Nevertheless, the scientists say that because they found a chronological correlation - changes in unemployment were then followed by changes in cancer mortality - it is probable that there is a causal link.