The U.S. is spending trillions of dollars on health care, but it’s not making a difference for cancer patients, according to a study published the Journal of the National Comprehensive Cancer Network. Researchers at The University of Texas MD Anderson Cancer Center investigated the effect that socioeconomic status (SES) and health expenditures have on cancer outcomes and mortality.

They extracted gross domestic product (GDP) and health expenditure per capita from the 2009 Bureau of Economic Analysis and CMS, respectively. Data from the National Cancer Institute (NCI) was then used to retrieve breast, colorectal and all-cancer age-adjusted rates and computed mortality/incidence (M/I) ratios for each population.

After assessing the data, the researchers found that health care spending wasn’t connected to better outcomes and lower mortality for colorectal cancer and all-cancer populations. But state-level SES and wealth does have a positive impact on cancer outcomes and mortality.
An assessment of the GDP and M/I ratios for each patient revealed that there’s a rift between northern and southern states in all three patient populations. The patients in southern states fared worse than those in the northern states.

Breast cancer was the only type of cancer in which health care spending led to lower M/I. The researchers assume that could indicate the effectiveness of screening, navigator programs, advocacy organizations and other state-level initiatives.

A counterpoint editorial in the same issue written by Dr. Melissa A. Simon and her colleagues at Robert H. Lurie Comprehensive Cancer Center of Northwestern University and Rush University warned against allowing the data to guide – or misguide – policymakers.

"Increased spending does not necessarily improve quality of care, but capping or cutting spending on health care does not necessarily solve problems either," Simon wrote.

The study’s lead researcher, Dr. Jad Chahoud, and his team agree with that. In the counterpoint, they explained that the goal of their study was not to misguide policy makers, but to highlight the disparity and encourage the discussion at the national level.

"We are not recommending the 'capping' of health care spending,” Chahoud wrote. “Instead, we are advocating for smart spending because complementing financial resources with other community-based and low-cost preventive measures is critical, especially in prevalent cancers, such as breast and colorectal."

In the editorial, Simon also noted that the data used for the study was from before the Affordable Care Act was enacted. He believes that there needs to be further study and analysis to understand the interplay between wealth and health expenditures and its relationship to cancer screening.

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