Evidence map›Paper›PMID 41084067›Full record

ArticleArchives of public health = Archives belges de sante publique2025

The economic burden of lung cancer in low- and lower-middle-income countries: a systematic review.

Elyesa Ünal, Elena Goodchild, Volker Winkler, Stephan Brenner, Andreas Deckert, Peter Dambach, Olaf Horstick, Andrea Kaifie, Valérie R Louis

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Archives of public health = Archives belges de sante publique, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Lung Cancer Screening and Prevention: Beyond Conventional Strategies in a Rapidly Changing Global Milieu.American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Elyesa ÜnalInstitute for Occupational, Social, and Environmental Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany. uenal.elyesa@gmail.com.
Elena GoodchildHeidelberg Institute of Global Health, University Hospital and Medical Faculty, University of Heidelberg, Heidelberg, Germany.
Volker WinklerHeidelberg Institute of Global Health, University Hospital and Medical Faculty, University of Heidelberg, Heidelberg, Germany.
Stephan BrennerHeidelberg Institute of Global Health, University Hospital and Medical Faculty, University of Heidelberg, Heidelberg, Germany.
Andreas DeckertHeidelberg Institute of Global Health, University Hospital and Medical Faculty, University of Heidelberg, Heidelberg, Germany.
Peter DambachHeidelberg Institute of Global Health, University Hospital and Medical Faculty, University of Heidelberg, Heidelberg, Germany.
Olaf HorstickHeidelberg Institute of Global Health, University Hospital and Medical Faculty, University of Heidelberg, Heidelberg, Germany.
Andrea KaifieInstitute for Occupational, Social, and Environmental Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Valérie R LouisHeidelberg Institute of Global Health, University Hospital and Medical Faculty, University of Heidelberg, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLung Cancer is one of the four most frequent malignant neoplasms in the world, and first in mortality. In 2020, lung cancer resulted in roughly 1.8 million deaths globally. Lung cancer is a major public health problem in low and lower-middle income countries, where high rates of tobacco smoking, environmental pollution, and limited access to healthcare resources contribute to a significant burden of the disease. The objective of our review was to compare costs among available countries and identify major cost drivers.

methodsA systematic database search was performed according to PRISMA guidelines on Web of Science, PubMed, Cochrane, EBSCO, ISPOR, and Google Scholar using a pre-defined search string. Studies were screened for eligibility and included if they provided information about the direct and indirect costs of lung cancer in low- and lower-middle-income countries. Search cut off was on August 4, 2025. The data from included studies were extracted, quantitatively synthesized, and compared.

resultsOf 2,383 articles, 15 met the inclusion criteria. All studies were conducted in low- and lower-middle-income countries, with a time frame ranging from 2003 to 2025. Most studies estimated costs based on prevalence. Most studies reported total healthcare costs as direct costs related to lung cancer; seven studies reported on indirect costs. Total average direct costs ranged from USD 2,540.66 per patient in Nepal to USD 10,179.98 per patient in the first year of treatment in Bolivia. Indirect costs varied from USD 140,995,744.13 in Bangladesh to USD 320,427,043.97 in Vietnam for their given respective sample sizes. Cost estimates varied substantially even for the same country depending on study's analytical focus, timeframe, and other methodological considerations.

conclusionIn conclusion, the costs of lung cancer are substantial and increase with disease progression, encompassing both direct and indirect components. High out-of-pocket expenditures further intensify the economic burden on patients and may lead to an underestimation of the true societal costs. The lack of standardized methodologies and robust data highlights the need for further research to guide effective policy and resource allocation in LMICs.

trial registrationRegistration: PROSPERO, ID CRD42020160370.

Indexed as

Developing countriesDirect costsEconomic burdenIndirect costsLower-middle-income countriesLow-income countriesLung cancerLung neoplasms

Identifiers

PMID41084067
PMCPMC12516874

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.