Diverging Trends in Premature Mortality and Productivity Losses of Lung and Pancreatic Cancer in Central and Eastern Europe, 2010 - 2021.

BACKGROUND: Cancer-related premature mortality imposes substantial economic losses through reduced productivity. Lung and pancreatic cancers remain among the leading causes of years of life lost (YLL) in Central and Eastern Europe (CEE), yet their indirect economic impact has been insufficiently quantified. This study quantifies years of life lost (YLL) and the associated productivity losses in nine CEE countries between 2010 and 2021. METHODS: YLL data were drawn from the WHO Global Burden of Disease database for Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, Serbia, Slovakia, and Slovenia. Productivity losses for individuals dying before age 65 were estimated using the human capital approach (HCA), multiplying years of productive life lost by country specific average full time adjusted salary adjusted for labor force participation and discounted at 3% annually. RESULTS: YLL attributable to lung cancer declined substantially across the CEE region, falling from 1,694,868 to 1,472,743 between 2010 and 2021. In contrast, YLL from pancreatic cancer increased across most CEE countries over the same period, rising from 375,802 to 395,652. Total productivity loss attributable to working-age lung cancer mortality declined from €6.37 billion to €4.33 billion, while pancreatic cancer productivity losses remained relatively stable at approximately €1.29 - 1.21 billion. Poland, Hungary, and Romania accounted for the largest absolute burden. CONCLUSIONS: Despite meaningful reductions in lung cancer YLL between 2010 and 2021, both cancers impose a formidable and ongoing economic toll across CEE. The near-stable pancreatic cancer burden contrasts with improvements in lung cancer and highlights an emerging policy priority. Targeted interventions in early detection and equitable access to therapy remain essential.