Years of potential life lost and indirect costs of melanoma and non-melanoma skin cancer: a systematic review of the literature.

Skin cancer is the most common form of cancer in the US, and an important public health concern both in the US and throughout the world. Given high incidence rates among young adults and the large number of deaths, skin cancer has the potential to result in significant years of potential life lost (YPLL) and lost productivity. The purpose of this study was to systematically review the published literature on the YPLL and the value of productivity loss from morbidity and premature mortality resulting from melanoma and non-melanoma skin cancer (NMSC). Employing pre-defined search terms and inclusion/exclusion criteria, systematic searches were conducted in MEDLINE, EMBASE, CINAHL and Econlit. We selected studies that measured the societal burden of melanoma and NMSC - through estimating either the YPLL and/or the indirect costs. We identified 16 relevant studies meeting our criteria, six were from the US and ten were from other industrialized countries; ten of the studies reported results on YPLL, eight on mortality costs and five on morbidity costs. Some studies reported results in more than one category. From each eligible article and report, we extracted detailed information on the study population/country, study design, data analysis methods and study results. Data abstracted for each eligible study included estimated number of YPLL, YPLL per death and morbidity and mortality costs. The average number of YPLL per death was approximately 15 for melanoma and 10 for NMSC. We found the costs attributable to melanoma and NMSC ranged from $US39.2 million to $US28.9 million for morbidity and $US3.3 billion to $US1.0 billion for mortality, respectively. It is clear from the published literature that skin cancer leads to significant YPLL and indirect costs associated with premature mortality and morbidity. Prevention and early detection efforts are important in helping reduce the incidence of melanoma and NMSC, and the related deaths and productivity losses.