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Cancer Epidemiol. 2018 Apr;53:27-34. doi: 10.1016/j.canep.2017.12.013. Epub 2018 Jan 30.

Productivity losses due to premature mortality from cancer in Brazil, Russia, India, China, and South Africa (BRICS): A population-based comparison.

Author information

National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland; University of Technology Sydney, Building 5D, 1-59 Quay St, Sydney 2007, Australia. Electronic address:
Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, United Kingdom.
National College of Ireland, Mayor Street IFSC, Dublin 1, Ireland.
Petrov Research Institute of Oncology, University of Tampere, Russian Federation, 68 Leningradskaya St, Pesochny 197758, St Petersburg, Kalevantie 4, Tampere, 33100, Finland.
International Agency for Research on Cancer, 150 Cours Albert Thomas, 69008, Lyon, France.
Brazilian National Cancer Institute, Rua Marques de Pombal, 125-7o. andar-Centro, Rio de Janeiro, Brazil.
Healis - Sekhsaria Institute of Public Health, 501 Technocity, Plot X-4/5A, MIDC, TTC Industrial Aarea, Mahape, Navi Mumbai 400 701, India.
Chinese Academy of Medical Sciences and Peking Union Medical College, 9 Dongdan 3rd Alley, DongDan, Dongcheng Qu, Beijing 100006, China.
Cancer Council Australia, Level 14/447 Pitt St, Sydney 2000, Australia.



Over two-thirds of the world's cancer deaths occur in economically developing countries; however, the societal costs of cancer have rarely been assessed in these settings. Our aim was to estimate the value of productivity lost in 2012 due to cancer-related premature mortality in the major developing economies of Brazil, the Russian Federation, India, China and South Africa (BRICS).


We applied an incidence-based method using the human capital approach. We used annual adult cancer deaths from GLOBOCAN2012 to estimate the years of productive life lost between cancer death and pensionable age in each country, valued using national and international data for wages, and workforce statistics. Sensitivity analyses examined various methodological assumptions.


The total cost of lost productivity due to premature cancer mortality in the BRICS countries in 2012 was $46·3 billion, representing 0·33% of their combined gross domestic product. The largest total productivity loss was in China ($28 billion), while South Africa had the highest cost per cancer death ($101,000). Total productivity losses were greatest for lung cancer in Brazil, the Russian Federation and South Africa; liver cancer in China; and lip and oral cavity cancers in India.


Locally-tailored strategies are required to reduce the economic burden of cancer in developing economies. Focussing on tobacco control, vaccination programs and cancer screening, combined with access to adequate treatment, could yield significant gains for both public health and economic performance of the BRICS countries.


Cost of illness; Developing countries; Economics; Health services needs and demand; Health services research; Mortality; Neoplasms; Premature; Work

[Indexed for MEDLINE]

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