The San Francisco Cancer Initiative (SFCI) is a community-based coalition focused on reducing the burden of five common cancers—breast, lung, prostate, colorectal, and liver—for which there are proven methods of prevention and detection, and for which effective treatments are known. The initiative can serve as a model for municipalities seeking to build coalitions of stakeholders to address public health issues.

Missing from this coalition of government, academic, health system, and community stakeholders is the San Francisco business community at large. Clearly, employers have a stake in the success of this initiative given cancer's impact on employees' lives. Yet their businesses will also benefit if improved prevention, detection and treatment reduces costly lost work time from cancer-related disability leaves from work.

Our analysis of employer-based, private short- and long-term disability (STD & LTD) claims in IBI’s Health and Productivity Benchmarking database shows just how hard these cancers hit businesses when a person enters the disability system. The average liver or lung cancer disability case cost around $16,000—about 40% of which are for long-term disabilities that can keep employees off the job for years. By comparison, disability costs for other cancers ranged from about $8,000 to $14,000—or between 20% and 137% higher than costs for other disability cases.

Considering that many employers incorporate cancer screening programs as part of their benefits strategies—to say nothing of—their pivotal roles as payers for health insurance—efforts to engage the business community as coalition partners would undoubtedly strengthen collective cancer control efforts.