ABSTRACT

Analysis of the Socio-Economic Consequences of Cancer in Nepal

In developing countries especially due to data scarcity, studies estimating the economic burden of a rapidly growing non communicable disease, cancer is rare. Our project funded by the American Cancer Society and implemented by The Nepal Study Center (NSC) was a first of a kind comprehensive survey of cancer patients undertaken in Nepal. In 2016, NSC undertook a survey of 600 cancer patients and 200 non-cancerous patients across five different hospitals of Nepal.  The range of the survey extended in understanding the economic hardships that a cancer patient and their family goes through the process of treatment. Questions were asked on the nature of mental burden, social isolations, family level distress, and labor market implications of a cancer patient. The project led to a doctoral dissertation and yielded opportunities for future research with two subsequent grants from American Cancer Society.

The broader themes of research that emerged from the survey are as follows: First, it was aimed at understanding the retrospective preference of cancer patients in valuing an annual comprehensive cancer-screening program. A structural equation-modeling framework determines how current health status of cancer patients determine their preferences for a preventative screening. Second, a comparative analysis of the cancer and control patients was done to estimate the incremental amount of burden (financial and non-financial) a family with cancer patient borne. It extended the literature by studying the differential impact of gender and cancer sites across different categories of patients.

Using propensity score matching methods, it was found that cervical cancer is not only the most prevalent cancer in Nepal, but they also face the highest mental burden pointing to dysfunctional familial relationships. Finally, to highlight a macro picture of the magnitude of economic burden that low resource-setting country like Nepal face, a mortality cost estimations of Nepal was undertaken. This was the first paper to project a social loss due to cancer through estimation of the number of life years lost and the amount of productivity loss.

Funding agency: American Cancer Society

Graduate Student: Soumi Roy Chowdhuri