The costs of cancer care grow exponentially. It has been argued that there is a linear relation between costs and outcome: the more a country spends on cancer care, the better the outcome. We try to dispel this myth, by showing that the relation is not linear at all and by describing other factors in the cancer care delivery process that have an impact on outcome.We show that there is a correlation between health care expenditure and life expectancy at birth, but that there is no correlation between number of deaths per 100,000 and cost per person spent on cancer in general, neither in lung, breast, colorectal and prostate cancer. Furthermore, a decrease in survival can be related to accessibility, affordability or equity issues, but also to factors such as life style. In the real world the process of cancer delivery is complex and dynamic, with many (potential) innovations. When efficacy is proven and an innovation is considered clinically relevant, the innovation has to be incorporated in evidence based clinical guidelines. However, implementation in such a guideline is still no guarantee for optimal adoption and diffusion of an innovation.Cancer care delivery also goes beyond matters related to health-systems and cancer costs, new technologies, reimbursement agencies, hospitals, and health-care professionals by increasingly involving shared decision making. An optimal process of cancer care delivery consists of the use of new and existing diagnostic tests and treatment strategies of high quality and is effective, safe, patient centred, efficient and timely. Such health system is highly recommended and all stakeholders in society will benefit.

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doi.org/10.1016/j.jcpo.2014.01.001, hdl.handle.net/1765/72198
Journal of Cancer Policy
Department of Medical Oncology

Uyl-de Groot, C., de Vries, E., Verweij, J., & Sullivan, R. (2014). Dispelling the myths around cancer care delivery: It's not all about costs. Journal of Cancer Policy (Vol. 2, pp. 22–29). doi:10.1016/j.jcpo.2014.01.001