The economic burden of colorectal cancer in Europe in 2015 was €19.1 billion, with more than 60% of the total cost associated with loss of productivity and opportunity costs for informal carers, researchers reported in Lancet Gastroenterology and Hepatology.

The population-based cost-of-illness study included data from 2015 regarding colorectal cancer in 33 European countries (EUR-33). The investigators calculated the primary, outpatient, emergency, hospital care, and systemic anticancer therapy (SACT) costs, as well as the costs of premature death, temporary and permanent absence from work, and unpaid informal care due to colorectal cancer.

Univariable and multivariable regression were used to compare colorectal cancer health care costs per case with colorectal cancer survival and colorectal cancer personnel, equipment, and resources throughout the EUR-33 countries. The study authors also compared their findings regarding hospital care and SACT costs with 2009 data from the 27 member states of the European Union.

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In 2015, the overall cost of colorectal cancer in the EUR-33 was €19.1 billion, which included €7.5 billion (39.4% of the total economic burden) for health care costs (€12 per citizen or €2351 per patient), and €11.6 billion for non-health care costs (60.6% of the total economic burden).

The health care costs included hospital care costs (€3.3 billion; 43.4% of health care costs), SACT (€1.9 billion; 25.6%), outpatient care costs (€1.3 billion; 17.7%), primary care costs (€0.7 billion; 9.3%), and emergency care costs (€0.3 billion; 3.9%).

The non-health care costs included loss of productivity due to disability (€6.3 billion; 33.0%), premature death (€3.0 billion; 15.9%), and opportunity costs for informal carers (€2.2 billion; 11.6%).

The mean cost for managing a patient with colorectal cancer ranged from €259 in Cyprus to €36,295 in Hungary. The mean cost per case in the EUR-33 was €2351.

Hospital care costs as a proportion of health care costs varied widely among countries, ranging from €143.4 million (24.1%) of €594.9 million in Romania to €4.6 million (84.8%) of €5.4 million in Luxembourg. Hospitalization accounted for the largest proportion of overall and individual health care costs in 27 of the EUR-33 countries. SACT expenditures increased by 213.7% from 2009 to 2015.

The study authors noted several limitations to their findings. Their analysis is dependent on the data sources, which, with the exception of hospital care activity and SACT costs, are lacking for some countries. Additionally, the assumption that colorectal cancer visits to a general practitioner might equate to the proportion of colorectal cancer hospital discharges may not always be accurate.

“Comprehensive evaluation of the economic burden of colorectal cancer can provide vital intelligence to underpin better health policy implementation and more appropriate resource allocation,” stated the researchers. “Upfront investment in colorectal cancer infrastructure is more likely to not only reduce colorectal cancer deaths, but also to lessen the economic burden. Increased expenditure on pharmaceutical medicines might not necessarily be reflected in improved outcomes, particularly in Central and Eastern European countries, emphasizing the need to use resources most appropriately for this common malignancy.”

Disclosure: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Henderson RH, French D, Maughan T, et al. The economic burden of colorectal cancer across Europe: a population-based cost-of-illness study. Lancet Gastroenterol Hepatol. Published online July 27, 2021. doi: 10.1016/S2468-1253(21)00147-3

This article originally appeared on Gastroenterology Advisor