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Table 2 Methodologies and direct medical costs associated of yCRC versus aCRC

From: Direct medical costs of young-onset colorectal cancer: a worldwide systematic review

Study

Cost definition

Cost Components

Source of payment

Payer perspective

Cost per-capita CRC (2020 USD)

Cost per-capita aCRC (2020 USD)

Cost comparison (yCRC versus aCRC)

Chemotherapy

Radiation Therapy

Outpatient (visits)

Prescription medications

Inpatient (care)

Patient out-of-pocket

Private insurance

Public payer

Statistical method used

Findings

Studies estimating the annualized costs of prevalent disease

 Byun, 2014 [10]

Estimated costs associated with CRC. Only considered the cost of prescription medication if it was indicated for CRC treatment

 

Societala

Maleb

10–19 years: 16,078

20–29 years: 12,466

30–39 years: 10,156

40–49 years: 9,778

Femaleb

10–19 years: 16,801

20–29 years: 15,816

30–39 years: 14,044

40–49 years: 13,658

Maleb

50–59 years: 9,501

60–69 years: 8,430

70–79 years: 7,580

80–89 years: 6,649

90–100 years: 5,962

Femaleb

50–59 years: 12,148

60–69 years: 11,099

70–79 years: 11,530

80–89 years: 12,466

90–100 years: 12,509

N/A

N/A

 Zheng, 2016 [11]

Estimated the costs associated with and attributed to (i.e., net cost) a CRC diagnosis

Societala

 < 65 years

Totalc: 13,837

Outpatient: 7,021

Inpatient: 5,053

Medications: 1,595

Netd: 9,745

Outpatient: 5,597

Inpatient: 3,948

Medications: 650

 ≥ 65 years

Totalc: 14,997

Outpatient: 4,151

Inpatient: 5,942

Medications: 3,104

Netd: 5,537

Outpatient: 1,668

Inpatient: 2,970

Prescription: 726

N/A

N/A

 Huang, 2017 [12]

Estimated costs associated with CRC. Including 2 months prior to diagnosis until the survey date

 

Societala

 < 45 years: 11,918

45–54 years: 11,994

55–64 years: 10,748

 ≥ 65 years: 10,644

Generalized linear models

Not significant

 Tran, 2020 [13]

Estimated costs associated with CRC

  

   

Societal

 < 30 years: 2,263

30–39 years: 2,517

40–49 years: 2,335

50–59 years: 2,191

60–69 years: 1,932

 ≥ 70 years: 1,412

N/A

N/A

 Gigli, 2021[14]

Estimated cost of care related to rectal cancer treatment (i.e., cost calculation only included the cost of procedures and medications related to rectal cancer treatment)

  

Healthcare provider

15–49 years:

Initiale: 27,692

Continuingf: 3,709

Terminalg: 31,359

50–69 years:

Initiale: 24,083

Continuingf: 3,290

Terminalg: 25,450

70–79 years:

Initiale: 23,184

Continuingf: 2,444

Terminalg: 18,338

 ≥ 80 years:

Initiale: 18,214

Continuingf: 1,620

Terminalg: 7,311

N/A

N/A

Studies estimating the costs of incident disease

 Taplin, 1995 [17]

Estimated costs associated with colon cancer by phases of care

 

 

Healthcare providera

 < 65 years

Initiale: 28,013

Continuingf: 2,594

Terminalg: 30,046

65–79 years

Initiale: 27,614

Continuingf: 2,454

Terminalg: 22,179

 ≥ 80 years

Initiale: 26,802

Continuingf: 2,253

Terminalg: 19,575

Multivariate linear regression

Not significant

 Clerc, 2008 [16]

Estimated costs associated with CRC during the 12 months following diagnosis

 

 

Healthcare providera

 < 65 years: 46,624 h

Medical purchasesi: 12,101

Outpatient: 8,278

Inpatient: 24,988

65–74 years: 42,978 h

Medical purchasesi: $11,949

Outpatient: 7,485

Inpatient: 22,489

 ≥ 75 years: 38,668 h

Medical purchasesi: 7,492

Outpatient: 7,076

Inpatient: 23,192

Multivariate linear regression

Not significant

 Hall, 2015 [15]

Estimated costs associated with CRC, 6, 12 and 15 months following diagnosis

 

  

Healthcare provideri

 < 65 years

6 months: 19,097

12 months: 23,368

15 months: 25,319

 ≥ 65 years

6 months: 17,858

12 months: 19,929

15 months: 20,978

Multivariate linear regression

Not significant

 Laudicella, 2016 [18]

Estimated costs associated with CRC treatment

  

  

Healthcare provideri

 < 65 years

Stage 1/2

Year 1: 27,360

Year 2: 6,708

Year 3: 5,631

Year 4: 4,435

Year 5: 4,028

Year 6: 2,873

Year 7: 2,972

Year 8: 2,756

Year 9: 2,428

Stage 3/4:

Year 1: 35,206

Year 2: 11,774

Year 3: 8,163

Year 4: 6,734

Year 5: 4,910

Year 6: 4,169

Year 7: 4,798

Year 8: 3,763

Year 9: 2,701

 ≥ 65 years

Stage 1/2:

Year 1: 26,048

Year 2: 6,640

Year 3: 5,567

Year 4: 4,771

Year 5: 4,829

Year 6: 4,872

Year 7: 4,503

Year 8: 4,901

Year 9: 4,229

Stage 3/4:

Year 1: 28,277

Year 2: 9,437

Year 3: 7,459

Year 4: 6,006

Year 5: 5,668

Year 6: 5,420

Year 7: 3,739

Year 8: 4,629

Year 9: 3,769

N/A

N/A

 Ritzwoller, 2018 [19]

Estimated costs associated with CRC during the 12 months following diagnosis

  

 

 

Healthcare providera

 < 65 years

De Novoj: 89,945

Recurrentk: 61,935

 ≥ 65 years

De Novoj: 67,195

Recurrentk: 49,279

N/A

N/A

 Shi, 2019  [20]

Estimated costs associated with CRC treatment

  

 

Societala

2002–2011

 < 45: 7,151

45–54: 7,085

2009–2011

 < 45: 10,087

45–54: 9,846

2002–2011

55–64: 6,680

 ≥ 65: 6,933

2009–2011

55–64: 8,193

 ≥ 65: 8,354

N/A

N/A

 Goldsbury, 2021[21]

Estimated costs associated with colon and rectal cancer during the 12 months following diagnosis

 

  

Healthcare provider

45–54 years

Colon: 36,064

Rectal: 40,720

55- 64 years

Colon: 31,869

Rectal: 36,488

65–74 years

Colon: 29,723

Rectal: 30,754

 ≥ 75 years

Colon: 23,251

Rectal: 32,695

Multivariable gamma regression

Colon:

higher costs associated with age < 55 years old at diagnosis

Rectal:

higher costs associated with age < 65 years old at diagnosis

 Paszat, 2021 [22]

Estimated costs associated with CRC during the 12 months following diagnosis

 

  

Healthcare provider

20–49 years

44,291

65–74 years

41,063

N/A

N/A

 Utsumi, 2021[23]

Estimated costs associated with CRC within 3 years of diagnosis

  

Healthcare provider

30–39 years

Endoscopicl: 8,733

Surgicalm: 22,755

Palliativen: 55,713

40–49 years

Endoscopicl: 5,717

Surgicalm: 26,386

Palliativen: 72,016

50–59 years

Endoscopicl: 8,184

Surgicalm: 26,507

Palliativen: 80,516

60–69 years

Endoscopicl: 12,681

Surgicalm: 33,424

Palliativen: 78,840

70–71 years

Endoscopicl: 12,811

Surgicalm: 29,160

Palliativen: 70,936

N/A

N/A

  1. aExtrapolated payer prescriptive based on source of costing data
  2. bCalculated based on number of participants
  3. cCosts associated with a CRC diagnosis, including all-cause costs incurred after diagnosis
  4. dNet cost defined as the difference in healthcare spending among CRC cases and cancer-free controls
  5. eInitial phase of care, defined as ≤ 6 months after CRC diagnosis
  6. fContinuing phase of care, defined at the time in between initial and terminal phase of care
  7. gTerminal phase of care, defined as ≤ 6 months before all-cause mortality
  8. hIncludes cost of transportation to and from medical appointments, accounts for 2.5% of total cumulative medical expenditure
  9. iIncludes prescription medications, prothesis and ‘expensive’ chemotherapy agents
  10. jDe novo CRC patient defined as those without a prior cancer diagnosis
  11. kReccurent CRC patient defined as those previously treated for early-stage (I-III) CRC
  12. lPatients who received endoscopic treatment only
  13. mPatients who received radical surgery for resection of the primary tumor with or without adjuvant chemotherapy
  14. nPatients who were considered to have non-curable CRC
  15. Open dot () indicates uncertainty with regards to inclusion of said component in the study