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Global economic crisis tied to thousands of cancer deaths

The global economic downturn of 2008 to 2010 -- along with the rise in unemployment that came with it -- was associated with more than 260,000 excess cancer-related deaths, many of which were considered treatable, according to new research.

The study, published in The Lancet, also found that the effect was lessened in countries that had universal health coverage and in those that increased spending on health care during the study period.

"Higher unemployment due to economic crisis and austerity measures is associated with higher number of cancer deaths," senior study author Rifat Atun, professor of global health systems at the Harvard T.H. Chan School of Public Health, said in a statement. "Universal health coverage protects against these deaths. That there are needless deaths is a major societal concern."

Past studies have shown links between economic downturns and higher rates of suicide, heart disease, and overall deaths, but until now, little research has examined the relationship between economic hard times and cancer deaths.

For the study, Atun and colleagues analyzed data from 1990 to 2010 from more than 70 middle- and high-income countries worldwide, representing about 2 billion people.

The researchers looked at deaths associated with "treatable" cancers (those with survival rates exceeding 50 percent), including breast cancer in women, prostate cancer in men, and colon cancer in both genders. They also included a few types of what they called "untreatable" cancers -- those with five-year survival rates less than 5 percent -- including lung and pancreatic cancers.

The study showed that increases in unemployment were associated with increased deaths from all types of cancer included in the analysis. The link was strongest for the treatable cancers, which the study authors say suggests that a lack of access to medical care played a role.

Furthermore, the researchers found that in countries where the law mandates universal health coverage, the association between unemployment and excess cancer deaths disappeared. Increasing public spending on health care also helped control the negative health impact of unemployment increases.

"Cancer is a leading cause of death worldwide so understanding how economic changes affect cancer survival is crucial," said lead author Mahiben Maruthappu from Imperial College London. "We also found that public healthcare spending was tightly associated with cancer mortality -- suggesting healthcare cuts could cost lives."

In an accompanying editorial, Dr. Graham A. Colditz of the Washington University School of Medicine and Dr. Karen M. Emmons of the Kaiser Foundation Research Institute, say that the new data "add to the evidence that the implementation of universal health coverage would further reduce the toll of cancer by making it possible to implement evidence based treatments and prevention strategies that are already in hand."

While many countries across the globe see universal health care coverage as an important societal investment, the authors wrote, the United States does not -- and would benefit from doing so, they argue.

"The country might find the promise of improving treatments difficult to achieve without first providing coverage to those affected by cancer," they wrote. "Universal health coverage, specifically for all patients with cancer, would meet the Institute of Medicine recommendation to reduce disparities in access to cancer care for vulnerable and underserved populations."

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