Frankfurt In health policy, everything is currently revolving around the corona pandemic. With a view to the effective health burdens, however, other diseases still play a far more important role.
In addition to the 112,000 Covid deaths in Germany in the past two years, there have been around 1.9 million deaths from other causes, most of which are cardiovascular diseases, which are responsible for a third of all deaths.
Cancer follows in second place among the causes of death with an estimated 460,000 deaths since the beginning of 2020. In 2020 alone, according to data from the Federal Statistical Office, around 231,000 people died of “malignant neoplasms”, which corresponds to 23.5 percent of all deaths. Around 500,000 people develop cancer in Germany every year.
Measured in terms of the lost time and quality of life, the burden of cancer is to be rated even higher than the mere mortality figures suggest. The therapy is associated with many side effects, and cancer patients die comparatively young.
In 2019 around 7,000 people died of cancer in Germany before they had reached the age of 50. Almost 800 cancer victims were younger than 30 years. Cancer is by far the most important cause of illness-related death in young people.
A good quarter of all cancer deaths recently occurred in people younger than 70 years old. According to the latest available data, the average age at death from cancer is around 74 years.
On average, cancer patients die around four to five years earlier than people with cardiovascular diseases and an estimated seven to eight years earlier than the average Covid patient.
According to a study by the Robert Koch Institute, the corona pandemic cost around 305,000 years of life in Germany in 2020. The basis for the calculation was around 31,600 deaths with Covid-19 as the main cause of death and the assumption that each of these people lost an average of around 9.6 years of life.
For the remaining life expectancy, based on international calculation methods, “the maximum life expectancy measured in one of the 16 federal states at the age of death based on the 2016/2018 mortality tables of the Federal Statistical Office” was used. This should therefore be around 91 years on average.
Measured against this standard, the more than 230,000 deaths from cancer in Germany result in a loss of almost four million years of life per year, whereby the loss of quality of life due to therapies and diseases is not even taken into account. De facto, cancer causes a disease burden every year that comes close to worst-case corona scenarios.
Most cancer patients die from lung cancer
Cancer is also an enormous burden worldwide. This is shown, for example, by the latest analyzes as part of the Global Burden of Disease Study, a study initiated by the WHO and Harvard University to collect global disease data. According to this, around 250 million healthy life years (disease-adjusted life years, DALY) are lost worldwide every year as a result of cancer.
Almost a quarter of them are caused by lung cancer and around ten percent by colorectal cancer. On a global level, cancer is now the second largest negative factor for health. Since 2010, the annual loss of years of life has increased by 16 percent.
However, the analysis recently published by scientists from Washington University in the journal “Jama Oncology” also conveys some positive signals: the age-standardized cancer incidence then stopped growing between 2010 and 2019, and the mortality rate fell by 5.9 percent. This leads to cautious optimism that progress has been made in early diagnosis and treatment, the authors write. However, these improvements were mostly concentrated in high-income countries.
According to data from the RKI, the age-standardized cancer death rates in Germany fell by twelve percent for men and five percent for women between 2009 and 2019. The average age at death from cancer increased by about two years during this period.
The pharmaceutical industry is likely to have contributed to this positive trend over the past two decades with several new approaches and classes of active ingredients, including, above all, targeted active ingredients against the growth drivers of cancer cells as well as innovative immunotherapies.
In the case of leukemia and breast cancer in particular, as well as, in some cases, lung, colon and skin cancer, these therapies brought progress and improved survival rates. Thanks to these successes, cancer drugs advanced to become the top-selling product category in the drug market.
German pharmaceutical companies only play a small role in the fight against cancer
However, German researchers and companies were hardly involved in this upswing in cancer therapy. Rather, the new concepts and therapy classes were predominantly developed by scientists in the USA as well as in Switzerland and Great Britain.
Innovative cell therapies have shown great success in combating leukemia in recent years. Here a genetically modified chimera antigen attacks receptor cells in order to destroy the tumor.
(Photo: © eye of science / Agentur Focus)
The established German pharmaceutical manufacturers Bayer, Merck and Boehringer have therefore so far only played a very subordinate role in the global oncology business, with a combined share of sales of at most two to three percent.
After all, there are now signs of a certain trend reversal. All three companies have stepped up their oncology research over the past few years. Bayer and Merck have recently registered several successes, albeit in niche areas.
In addition, the German biotech scene is now more represented in oncology research. Around half a dozen German biotech companies, for example, are working on novel cell therapies against cancer. Mainz-based Biontech is also pursuing various other new approaches, including mRNA-based cancer vaccines. The company is now testing a total of 16 potential cancer drugs in clinical trials.
How successful all these projects are will only become clear over the next few years. But it is also clear that the need for better cancer therapies will remain huge for the foreseeable future.
More: In the shadow of the pandemic – How the oncology leader gives hope to millions of cancer patients