Research reveals the economic burden of colorectal cancer across Europe

New research led by Queen’s University Belfast has found that colorectal cancer costs Europe a staggering €19.1 billion (£16.3 billion) per year. This figure includes direct expenditure as well as indirect costs including premature death and sick leave.

Colorectal cancer is the second leading cause of cancer death in Europe, with one European dying of colorectal cancer every three minutes. In the UK, over 16,000 people die of this common disease every year.

This new research demonstrates the tremendous economic burden that colorectal cancer places on health systems, patients and their families, and highlights the significant inequalities that European colorectal cancer patients experience, depending on where they live.

The study also highlights how a higher spend on cancer drugs than on hospital care, did not always lead to better patient outcomes.

The research, published in high impact journal Lancet Gastroenterology and Hepatology, found the economic cost of colorectal cancer in Europe to be €19.1 billion (£16.3 billion) and €2.01 billion (£1.7 billion) in the UK.

This figure breaks down into direct expenditure on colorectal cancer care in Europe to €7.5 billion (£6.4 billion), just under 40 per cent of the total cost. In the UK the figure is €361 million (£307.8 million), at 18 per cent of total cost. The indirect economic impact, which measures the costs of premature death, temporary and permanent absence from work, and unpaid informal care, was €11.6 billion (£9.9 billion), over 60 per cent of the total cost. In the UK the figure is €1.65 billion (£1.4 billion), at 82 per cent of total cost.

Senior author on the paper, Professor Mark Lawler, Associate Pro-Vice Chancellor and Professor of Digital Health at Queen’s University Belfast and Scientific Director of DATA-CAN, the UK’s Health Data Research Hub for Cancer, said: “Our research highlights the enormous impact that colorectal cancer has, not only on the health of our citizens, but also increasingly on the financial prosperity of patients, their families, health systems and economies. By not investing appropriately in services such as screening, early diagnosis and treatment, we have created an economic time bomb that is placing an untenable burden on our health systems and on society.

“It’s not what you spend, it’s the way that you spend it. We must ensure that we use our precious healthcare resources in a way that ensures better outcomes for patients but delivered with cognisance of the financial pressures that health systems currently face, particularly in the context of Covid.”

The research also found a wide variation in the economic burden of colorectal cancer across Europe. Countries with similar gross domestic product (GDP) per head of population had widely varying health-care expenditures on colorectal cancer, leading to significant inequalities for colorectal cancer patients, depending on where they live in Europe.

This trend is worrying. It highlights economic inequalities that may impact significantly on patients’ outcomes and their quality of life.”

Dr Raymond Henderson, Study Lead Author, Queen’s University Belfast Knowledge Transfer Partner Fellow at Diaceutics, Belfast

Expenditure on cancer drugs was found to have increased by over 200 per cent on average over a six-year period but was not necessarily associated with better outcomes. This was particularly the case in Eastern Europe where in countries such as Bulgaria (+818 per cent) and Hungary (+398 per cent), expenditure on cancer drugs was higher than hospital care costs (unlike the EU average) but was associated with poorer outcomes.

The UK was one of several countries in the EUR-33 to spend significantly more on cancer drugs (€151 million (£128.8 million); 42 per cent of total costs) than on hospital care (€117 million (£99.8 million); 32 per cent of total costs), but this did not correlate with improved outcomes for patients.

Several central and western European countries also had significantly increased spend on cancer drugs (notably Ireland (+473 per cent) and Austria (+369 per cent)), mostly due to increases in the use of targeted cancer drugs. In the UK, spend on cancer drugs went up by 352 per cent, from €33 million to €151 million (£28.1 million to £128.8 million).

Professor Declan French, Professor of Finance from Queen’s Management School and co-author of the study, said: “This is a very important piece of work on a common cancer with significant implications for the financing of health systems. It highlights how transdisciplinary cross-faculty research, bringing together expertise in finance and health from across the University, can give unique insights into health spending that can influence health policy and potentially enhance patient care.”

Professor Richard Sullivan, Director of the Institute of Cancer Policy at Kings College London and co-author on the paper, said: “This paper is the most comprehensive to date on the economic burden of colorectal cancer across Europe. Our results have major implications for guiding policy and improving outcomes for this common malignancy.”