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Estimated economic burden of cancer associated with suboptimal diet in the United States

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Abstract

Purpose

Suboptimal diet is a preventable cause of cancer. We aimed to estimate the economic burden of diet-associated cancer among US adults.

Methods

We used a Comparative Risk Assessment model to quantify the number of new cancer cases attributable to seven dietary factors among US adults ages 20 + years. A Markov cohort model estimated the 5-year medical costs for 15 diet-associated cancers diagnosed in 2015. We obtained dietary intake from 2013 to 2016 National Health and Nutrition Examination Survey, cancer incidence, and survival from 2008 to 2014 Surveillance, Epidemiology, and End Results (SEER) program, and medical costs from 2007 to 2013 linked SEER-Medicare data.

Results

The estimated 5-year medical costs of new diet-associated cancer cases diagnosed in 2015 were $7.44 (2018 US$). Colorectal cancer had the largest diet-related 5-year medical costs of $5.32B. Suboptimal consumption of whole grains ($2.76B), dairy ($1.82B), and high consumption of processed meats ($1.5B) accounted for the highest medical costs. Per-person medical costs attributable to suboptimal diet vary by gender, race, and age group.

Conclusions

Suboptimal diet contributes substantially to the economic burden of diet-associated cancers among US adults. This study highlights the need to implement population-based strategies to improve diet and reduce cancer burden in the US.

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Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

The codes used during the current study are available from the corresponding author on reasonable request.

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Acknowledgments

We acknowledge Dr. Angela Mariotto from the Division of Cancer Control and Population Sciences, National Cancer Institute for providing valuable data inputs related to direct medical costs of cancer care. We acknowledge Dr. Trevor Thompson from the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention for modeling guidance. These individuals received no compensation for this work.

Funding

Drs. Zhang, Mozaffarian, Cudhea, Ruan, and Shan were supported by NIH/R01MD011501.

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Author notes

  1. Fang Fang Zhang Senior author.

Authors and Affiliations

  1. Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30328, USA

    Jaya S. Khushalani, Donatus U. Ekwueme & Diane M. Harris

  2. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA

    Frederick P. Cudhea, Mengyuan Ruan, Dariush Mozaffarian & Fang Fang Zhang

  3. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Zhilei Shan

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  1. Jaya S. Khushalani
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Contributions

Jaya Shankar Khushalani (J.S.K), Fang Fang Zhang (F.Z), and Donatus Ekwueme (D.E) designed research; J.S.K and Frederick Cudhea (F.C.) conducted research; J.S.K, F.C, Zhilei Shan (Z.S), and Mengyuan Ruan (M.R) analyzed data. J.S.K wrote the first draft and all authors commented on the previous versions of the manuscript. J.S.K had primary responsibility for final content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jaya S. Khushalani.

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Conflict of interest

Dr. Mozaffarian reports honoraria or consulting from AstraZeneca, Acasti Pharma, GOED, Haas Avocado Board, Nutrition Impact, Pollock Communications, Boston Heart Diagnostics, and Bunge; scientific advisory board, Omada Health and Elysium Health; chapter royalties from UpToDate, and research funding from National Institutes for Health and Gates Foundation. All other authors have no financial disclosures. The authors have no conflicts of interest to declare that are relevant to the content of this article.

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Khushalani, J.S., Cudhea, F.P., Ekwueme, D.U. et al. Estimated economic burden of cancer associated with suboptimal diet in the United States. Cancer Causes Control 33, 73–80 (2022). https://doi.org/10.1007/s10552-021-01503-4

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  • DOI: https://doi.org/10.1007/s10552-021-01503-4

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