The more a European Union national government spends on healthcare, the fewer the deaths after a cancer diagnosis, says new research presented at the European Cancer Congress.
Higher levels of wealth and health spending are strongly associated with both increased cancer incidence and decreased cancer mortality; for breast cancer, higher health spending seems to be even more strongly associated with better outcomes, says the study, which is also published in the Annals of Oncology.
Also, despite many initiatives to standardise public health policies, there is significant variation between health expenditure and cancer incidence and mortality in the 27 EU member states, especially between the Western and Eastern European countries, add authors Felipe Ades of Belgium’s Breast European Adjuvant Studies Team (BrEAST) et al.
Western Europe has around 400 million people, four times more than Eastern Europe, and western countries’ total Gross Domestic Product (GDP) is more than 10-fold higher. Per capita health expenditure is strongly correlated with GDP per capita and with the percentage of GDP spent on health, says Dr Ades.
The cut-off point between Eastern and Western European countries for annual per capita health expenditure is around $2,600. At $2,690, Portugal has Western Europe’s lowest per capita expenditure, while Slovenia has the East’s highest per capita expenditure, at $2,551. In the West, Luxembourg spent the most per person per year - $6,592 – while in the East, Romania spent the least - $818, he notes.
And, proportionately, Eastern Europe has lower cancer incidence and higher cancer mortality (except for Cyprus), while the opposite is the case in Western Europe.
In countries spending under $2,000 per capita on healthcare - like Romania, Poland and Hungary - around 60% of patients die after a cancer diagnosis, while in countries spending $2,500-$3,500 – such as Portugal, Spain and the UK - this figure is 40%-50%. In countries spending around $4,000 – including France, Belgium and Germany – less than 40% of the patients die, the researchers also report.
While the study does not analyse the reason for the higher incidence of cancer in Western European nations, it suggests that, as deaths in these countries do not increase in the same proportion as incidence, it may be due partly to greater numbers of screening programmes in Western countries, detecting more cancers at their early, more treatable stages, and the availability of effective treatments in these nations.