Samhällskostnaderna för hudcancer i Sverige

Skin cancer is the cancer type with the highest prevalence in Sweden and in 2022, Sweden had the fifth highest age-standardised incidence of skin cancer in the world. The Swedish Radiation Safety Authority has previously published a report where the total societal costs for skin cancer in Sweden in 2011 were estimated to be 1.6 billion Swedish crowns. Since then, there have been changes with both an increased incidence and introduction of new treatments which can influence costs related to skin cancer in different ways. The aim of this study was to conduct an updated calculation of the societal costs of skin cancer in Sweden. The analysis included the diagnoses melanoma, squamous cell carcinoma and basal cell carcinoma. Even precancerous sun damage such as actinic keratosis, squamous cell carcinoma and melanoma in situ, as well as melanocytic nevi, are included. The total societal costs for skin cancer were estimated to be 2 billion Swedish crowns in 2023. Direct costs accounted for the majority of the costs (65%) and were estimated to be 1.3 billion Swedish crowns. The remaining costs (35%) consisted of indirect costs related to productivity loss and were calculated to be 696 million Swedish crowns. The largest single cost item were costs for productivity loss related to death which was estimated at 609 million Swedish crowns and thus 31% of the total costs, followed by costs for specialised outpatient care (554 million Swedish crowns, 28%) and primary care costs (291 million Swedish crowns, 15%). Costs for prescription drugs were estimated to be 276 million Swedish crowns (14%), inpatient care costs to be 148 million Swedish crowns (7%) and costs for short-term productivity loss to be 82 million Swedish crowns (4%). The two smallest cost items were costs for municipal palliative care and long-term productivity loss, which were calculated to be 14 and 11 million Swedish crowns, respectively (0.7% and 0.2%). Malignant melanoma of the skin (C43) was the single largest cost item among the included diagnoses and was calculated to cost 1.2 billion Swedish crowns or 72% of the diagnosis-related costs. Approximately half of the costs for melanoma consisted of productivity loss related to premature death. The diagnosis code which accounted for the second highest costs was C44 (Other malignant neoplasms of the skin) which were calculated to be 243 million Swedish crowns (14%). The costs for D22 (Melanocytic nevi) and L57.0 (Actinic keratosis) were estimated to be 140 and 92 million Swedish crowns, respectively (6% and 5%). Although accounting for only approximately 6% of the total diagnosis-related costs, the diagnosis of melanocytic nevi generated the highest primary care costs which was estimated at 106 million Swedish crowns. The diagnostic codes D04 (Carcinoma in situ of the skin) and D03 (Melanoma in situ) accrued the smallest share of costs which were calculated to be 5 and 2 million Swedish crowns, respectively, in 2023. The 2023 costs for skin cancer, which were estimated to be 2 billion Swedish crowns in this report, can be compared to the 2011 costs of skin cancer which were calculated to be 1.6 billion Swedish crowns (approximately 2 billion Swedish crowns if price-adjusted to 2023) by the Swedish Radiation Safety Authority. This indicates that the total costs are similar despite an increase of approximately 80% in the number of skin cancer cases per 100 000 during the same period. The increase in skin cancer cases did not include basal cell carcinoma. This means that the cost per case has not increased to the same extent as the increase in number of diagnosed patients. One contributing factor to this is that there are more individuals who are diagnosed in earlier stages where treatment is less costly. Another explanation could be that there are fewer who die in younger ages due to among other things effective treatment which decreases the productivity loss due to premature death for persons of working age. To summarise, the calculations in this report show that there are significant societal costs related to skin cancer. Due to an increased general disease burden with a growing and ageing population, a wider approach including prevention from different stakeholders in society as well as measures for early detection and treatment becomes more and more important to decrease the number of persons who are diagnosed with skin cancer.