Lung cancer: the looming economic crisis governments can’t ignore

Lung cancer carries a heavy cost – not only for the people diagnosed,  but for health systems and economies alike. Much of this burden could be mitigated through earlier detection and proactive treatment. So why does lung cancer still struggle to command political attention and investment?

Despite its widespread impact, lung cancer remains underprioritised in health policy. It isn’t included consistently in national cancer control plans, screening programmes are limited, and dedicated care pathways often absent.

This is both a human and an economic failure: lung cancer is the leading cause of cancer-related deaths globally, and numbers continue to rise rapidly. Yet detecting lung cancer earlier can dramatically improve survival and outcomes. Failing to act early comes at a price, in both lives and public spending.

Health systems and health budgets are already under strain. Investing in earlier detection is an economic imperative as much as it’s a clinical one. Government expenditure could be recouped quickly as, if done well, targeted investment reduces treatment costs and supports people to remain in or return to work, allowing people and their families to return to normality sooner.
 

The hidden cost of lung cancer

Lung cancer (together with tracheal and bronchial cancer) is projected to cost the global economy $3.9 trillion between 2020 and 2050 – more than any other cancer. Much of this stems from the great toll lung cancer takes on people, making staying or returning to work extremely difficult. Employment rates can drop considerably among people who are diagnosed with lung cancer – by more than 50% in one study.

The consequences are immediate. More than 70% of people who experience financial pressures after a lung cancer diagnosis are more likely to delay or forgo care, which can create a cycle where worse health leads to greater economic hardship.

Work, however, isn’t only about income. For many, it’s also part of their recovery and overall wellbeing, as well as their identity. A survey revealed that the vast majority (87%) of people with lung cancer said that continuing to work after their diagnosis was important to them. Some of these people (62%) indicated that work provided a sense of normality and helped them (55%) maintain a positive outlook. Therefore, supporting people to remain in work (if they choose to) could be seen as an important part of person-centred care.

The financial impact is not just isolated to people with the disease. Many carers may reduce or stop work entirely to provide support. In a US study, 35% of carers were found to have stopped working after their loved ones received a cancer diagnosis, and in Europe,  78% report experiencing financial difficulties.

Health systems bear a significant share of the burden too, particularly when lung cancer is diagnosed late. In the Netherlands alone, direct costs for lung cancer care exceeded €900 million in 2021 (against a population of 18 million). Late-stage diagnosis drives much of this expense, with costs nearly double those of early-stage care due to more complex and invasive treatment needs.
 

How can we reduce the costs of lung cancer?

There are several key areas for investment for governments:

• National screening programmes for lung cancer: Targeted low-dose computed tomography (LDCT) screening has a substantial evidence base for its cost-effectiveness at detecting lung cancer sooner, and reducing deaths from the disease. The difference is stark: while 5-year survival for people diagnosed at stage IV remains between 7 and 18%, follow-up data suggest that more than 80% of people diagnosed through screening could live for at least 20 years. Earlier diagnosis changes everything – costs, outcomes, lives.
• Specific care pathways for lung cancer: Clear, well-designed care pathways help ensure patients receive timely, guideline-aligned treatment. They support coordination across the health system, make more efficient use of resources, enable delivery of best-practice care and improve outcomes.
• Workforce and system capacity: Earlier diagnosis depends on systems that can respond quickly. This means investing in training primary care practitioners to recognise early signs of lung cancer, alongside initiatives such as rapid referral pathways to expedite diagnosis and treatment. It also requires ringfenced funding for lung cancer in national cancer control plans and robust monitoring to hold the system to account.

Lung cancer has been overlooked for far too long. Decisive investment in earlier detection, comprehensive care and stronger systems would save lives, protect long‑term economic stability, and ease the burden on families and society alike. Governments may ask whether they can afford to act, but the real question is: can we afford not to?