Regional inequalities in mortality from colorectal cancer and its indirect economic impact in Brazil from 2001 to 2030: a human capital approach study.

Background: Brazil contributes to 41% of colorectal cancer (CRC) deaths in Latin America. CRC is the second most incident cancer among males and females in Brazil, with wide regional variation. We aimed to estimate the years of potential life lost (YPLL) and the productivity lost due to mortality from CRC by region, between 2001 and 2030. Methods: We estimated the indirect costs of mortality from CRC using the Human Capital Approach. Mortality data (2001-2016) were obtained from the national Mortality Information System. Economic data were obtained from the Continuous National Household Sample Survey. Productivity lost was calculated for those aged over 15. Results for 2016-2030 were estimated based on the observed data (2001-2015). Findings: We estimated 635,253 deaths from CRC between 2001 and 2030, corresponding to 12·6 million YPLL and Int$22·6 billion in productivity losses. From 2001-2005 (observed) to 2026-2030 (estimated), CRC deaths are expected to increase by 181% and 165% among males and females, respectively. The largest relative increases among males will be observed in the North region, with productivity losses increasing 9·7-fold. Among females, North and Northeast regions will experience the highest increases in productivity lost, 8·7 and 10·3-fold respectively. Interpretation: CRC productivity loss will increase substantially by 2030, primarily due to increasing incidence and mortality, as a consequence of the epidemiological transition and health services access, especially in the North and Northeast regions. Implementing primary prevention, screening, early diagnosis and ensuring timely access to treatment is essential to reduce the economic impact of CRC overall and reduce regional inequities. Funding: This study was funded by the MSD Independent Oncology Policy Grant Program.