Finding cancer late carries a terrible price, in both lives and dollars. A new study led by researchers at the National Cancer Institute and American Cancer Society puts some startling numbers behind that familiar truth.
Using Medicare data on cancer patients aged 66 and older, researchers calculated that cancer-attributable medical costs averaged nearly $122,000 during the final year before a cancer death. Patients diagnosed after their cancers had already spread generally incurred the highest costs, while costs tended to be lower for earlier-stage disease.
Breast cancer offers an especially powerful example of the value of early detection. Among women whose breast cancer is caught before it spreads beyond the breast, five-year relative survival is 100%. Once the cancer has spread to distant parts of the body, it falls to 33.8%.
The lesson for policymakers is clear. Our health system should treat clinically appropriate early detection as high-value care — the kind that can save lives and reduce patients’ chances of facing the extraordinary costs and burdens of advanced disease. Efforts to restrict or delay access to screening in the name of financial prudence can be a false economy.
Breast cancer accounts for more than 15% of all new cancer cases in the United States. This year alone, an estimated 321,910 women will be diagnosed with the disease — and more than 42,000 will die from it.
The financial toll is enormous, too. Americans spent $29.8 billion on breast cancer medical care and prescription drugs in 2020 — more than on any other cancer.
Costs rise sharply as the disease advances. Among Medicare patients in the new study, oral prescription drugs during the first year after diagnosis averaged about $700 for women with early-stage breast cancer. For women with advanced disease, the figure was $25,000.
The evidence for appropriate screening is compelling. One model cited by the Centers for Disease Control and Prevention estimated that mammography every two years for women ages 50-74 cut breast cancer mortality by 26% compared with no screening. Another analysis estimated that screening reduced diagnoses of breast cancer that had already spread elsewhere in the body by 29%.
NITAZENES PROVE THAT THE PROBLEM OF SYNTHETIC DRUG USE CAN ALWAYS WORSEN
That doesn’t mean more screening is always better. Tests should be appropriate to a patient’s age and individual risk. But policymakers should be skeptical of bureaucratic hurdles that delay screening consistent with established medical guidelines. The American College of Radiology, for example, recommends an annual breast MRI for certain women at elevated risk. Yet some insurers require prior authorization for such scans.
Cost controls make sense when they weed out waste. They are penny-wise and pound-foolish when they delay appropriate tests that can catch a deadly disease before it becomes far harder, and costlier, to treat.
Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is The World’s Medicine Chest: How America Achieved Pharmaceutical Supremacy—and How to Keep It (Encounter 2025). Follow her on X @sallypipes.