Socio-economic consequences of cancer from the perspective of the individual and society including the impact of COVID-19 pandemic

Cancer is a major public health concern in Slovenia. The total prevalence of patients with cancer in Slovenia is predicted to rise substantially due to rising incidence and improved treatment outcomes. Patients with cancer are being cured at an increasing rate, but they are being handicapped in their everyday lives by the repercussions of the disease and/or therapy, which influence physical, emotional, and social well-being, as well as vocational rehabilitation. Cancer has significant socioeconomic effects at the individual and societal levels, which are understudied in Slovenia. The diagnosis of cancer affects the financial situation of an individual with cancer, including his/her family and not only through the costs incurred because of illness and its treatment not covered by health insurance, but also through the loss of income because of sick leave, job loss and career decline. Living with cancer usually results in long periods of sick leave due to treatment and functional impairment. Patients with cancer experience both subjective financial concerns as well as objective financial consequences of cancer, for which the term financial toxicity was coined. Financial toxicity is associated with several clinically relevant disease outcomes, namely health related quality of life, disease symptoms, treatment compliance and survival. It depends on many factors such as employment and marital status, type of cancer, gender and income. The extent of financial toxicity due to cancer in Slovenian patients is unknown, nor is its impact on disease outcomes and quality of life. Cancer has significant direct costs for the industry and public finances. The data show that the direct burden of cancer is increasing due to the cost of treatment and has doubled in Europe between 1995 and 2018. Expenditure on sick leave and pensions, which are linked to health reasons for retirement is also increasing. These trends will affect Slovenia even more than other countries, as it is one of the three countries in the EU with the fastest aging population. In addition, the proportion of cohorts in the population over the age of 50 is expected to increase over the next years. An interdisciplinary research project focuses on the socio-economic consequences of cancer assessed at three levels: individual (patients, families, and informal carers), firm (employers), and macroeconomic (health care, public finances, and broader socioeconomic aspects). A special emphasis will be placed on the immediate and long-term implications of the 2019 coronavirus pandemic (COVID-19) on cancer burden. The project's content is grounded in medicine (oncology), since the starting point is an analysis of cancer incidence, and the objective is to reduce the burden inflicted by cancer on individuals and society. It focuses on identifying the burden of cancer for the individual and the family through an analysis of the impact of cancer on the individual's career path and well-being (including material well-being), and is thus related to the long-term goals of decent work and inequality, as the project will reveal possible differences in well-being due to the burden of cancer, resulting in increased inequality. The project will also point out the differences in the burden of cancer by gender and the consequences for career development by gender. Due to the calculations of the burden on companies and public finances, the project relies heavily on topics covered in the context of business development, industry, and economic growth. In 2020, the COVID-19 outbreak shook the economy as well as healthcare systems all around the world. The treatment and comprehensive management of patients with cancer has also been disrupted. Therefore, one of the project’s goals will be also a comprehensive analysis of the long-term socio-economic consequences of delays in cancer diagnoses and treatment due to COVID-19 pandemic.