← Direct Medical CostOncoSystems Hub
References

Direct Medical Cost — References

The primary published studies providing observed cost estimates in the per-patient tool — direct medical, out-of-pocket and societal cost — with full references and DOIs.

Updated September 2026 · Primary cost studies from the CRC Lancet Commission review (folder “Included Papers for Analysis”). Systematic reviews, used only for the umbrella review, are not cost-data sources and are not listed here.
← Back to the mapView the data table →
  1. Alefan Q, Malhees R. Direct medical cost associated with colorectal cancer in north of Jordan.
    Current Problems in Cancer. 2017;41:371-381.
    doi:10.1016/j.currproblcancer.2017.05.001 · PMID 28629637
    Cited for: Jordan
  2. Azzani M, Yahya A, Roslani AC, Su TT. Catastrophic Health Expenditure Among Colorectal Cancer Patients and Families: A Case of Malaysia.
    Asia-Pacific Journal of Public Health. 2017;29:485-494.
    doi:10.1177/1010539517732224 · PMID 29019257
    Cited for: Malaysia
  3. Balkhi B, Alghamdi A, Alqahtani S, Al Najjar M, Al Harbi A, Bin Traiki T. Colorectal cancer-related resource utilization and healthcare costs in Saudi Arabia.
    Saudi Pharmaceutical Journal (Saudi Pharm J). 2023;31:101822 (issue 11).
    doi:10.1016/j.jsps.2023.101822 · PMID 38023384
    Cited for: Saudi Arabia
  4. Boman SE, Hed Myrberg I, Bruze G, Martling A, Nordenvall C, Nilsson PJ. Earnings and work loss after colon and rectal cancer: a Swedish nationwide matched cohort study.
    EClinicalMedicine. 2024;75:102770.
    doi:10.1016/j.eclinm.2024.102770 · PMID 39210942
    Cited for: Sweden
  5. Bugge C, et al. Phase- and gender-specific, lifetime, and future costs of cancer: A retrospective population-based registry study.
    Medicine (Baltimore). 2021;100:e26523.
    doi:10.1097/MD.0000000000026523 · PMID 34190187
    Cited for: Norway
  6. CROCODILE Study Group (Nepogodiev D, et al.). Catastrophic expenditure and treatment attrition in patients seeking comprehensive colorectal cancer treatment in India: A prospective multicentre study.
    The Lancet Regional Health - Southeast Asia. 2022;6:100058.
    doi:10.1016/j.lansea.2022.100058 · PMID 36408078
    Cited for: India
  7. Essue BM, de Oliveira C, Bushnik T, Fung S, Hwee J, Sun Z, Gomez Navas E, Yong JHE, Garner R. The Burden of Health-Related Out-of-Pocket Cancer Costs in Canada: A Case-Control Study Using Linked Data.
    Curr Oncol. 2022;29:4541-4557.
    doi:10.3390/curroncol29070359 · PMID 35877219
    Cited for: Canada
  8. Farina E, et al. Short-term effect of colorectal cancer on income: analysis of an Italian cohort.
    J Epidemiol Community Health. 2023;77:196-201.
    doi:10.1136/jech-2022-220088 · PMID 36707238
    Cited for: Italy
  9. Gigli A, Francisci S, Capodaglio G, et al. The Economic Impact of Rectal Cancer: A Population-Based Study in Italy.
    International Journal of Environmental Research and Public Health. 2021;18:474.
    doi:10.3390/ijerph18020474 · PMID 33430156
    Cited for: Italy
  10. Gorasso V, et al. The incremental healthcare cost associated with cancer in Belgium: A registry-based data analysis.
    Cancer Medicine (Cancer Med). 2024;13:e6659 (issue 3).
    doi:10.1002/cam4.6659 · PMID 38268318
    Cited for: Belgium
  11. Haltia O, Farkkila N, Roine RP, Sintonen H, Taari K, Hanninen J, Lehto JT, Saarto T. The indirect costs of palliative care in end-stage cancer: A real-life longitudinal register- and questionnaire-based study.
    Palliative Medicine. 2017;32:493-499.
    doi:10.1177/0269216317729789 · PMID 28895471
    Cited for: Finland
  12. Henaine AM, Chahine G, et al. Management of patients with metastatic colorectal cancer in Lebanese hospitals and associated direct cost: a multicentre cohort study.
    Eastern Mediterranean Health Journal. 2019;25:481-494.
    doi:10.26719/emhj.18.063 · PMID 31612980
    Cited for: Lebanon
  13. Henderson RH, French D, Maughan T, et al. The economic burden of colorectal cancer across Europe: a population-based cost-of-illness study.
    The Lancet Gastroenterology & Hepatology. 2021;6:709-722.
    doi:10.1016/S2468-1253(21)00147-3 · PMID 34329626
    Cited for: Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland
  14. Hu ZB, Huang JY, McDonald S, Chen BX, Mao HX, Wu Z, Dai XY, Yu H, Li JJ, Lin Y. Medical treatment cost for Chinese inpatients with colorectal cancer by sites.
    Front Public Health. 2025;13:1605887.
    doi:10.3389/fpubh.2025.1605887 · PMID 40567985
    Cited for: China
  15. Huang HY, et al. Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based, multicenter, cross-sectional survey.
    Chin J Cancer. 2017;36:41.
    doi:10.1186/s40880-017-0209-4 · PMID 28454595
    Cited for: China
  16. Huang SY, Chen HM, et al. Economic burden of cancers in Taiwan: a direct and indirect cost estimate for 2007-2017.
    BMJ Open. 2020;10:e036341.
    doi:10.1136/bmjopen-2019-036341 · PMID 33039986
    Cited for: Taiwan
  17. Jafari A, Alamdarloo PM, Dehghani M, Bastani P, Ravangard R. Economic Burden of Colorectal Cancer: A Case of Fars, Iran.
    Cancer Control. 2021;28:10732748211009952.
    doi:10.1177/10732748211009952 · PMID 33882706
    Cited for: Iran
  18. Karim MA, Talluri R, Shastri SS, Kum HC, Shete S. Financial Toxicities Persist for Cancer Survivors Irrespective of Current Cancer Status: An Analysis of Medical Expenditure Panel Survey.
    Cancer Res Commun. 2022;2:1119-1128.
    doi:10.1158/2767-9764.crc-22-0166 · PMID 36531523
    Cited for: United States
  19. Kaye DR, et al. System-Level Health-Care Integration and the Costs of Cancer Care Across the Disease Continuum.
    J Oncol Pract. 2018;14:e149-e157.
    doi:10.1200/JOP.2017.027730 · PMID 29443647
    Cited for: United States
  20. Kontiainen J, Lehtomaki K, et al. Disease-phase-specific resource utilization and healthcare costs in metastatic colorectal cancer: a subgroup analysis of the Finnish RAXO study.
    Scandinavian Journal of Gastroenterology. 2025;61:61-72.
    doi:10.1080/00365521.2025.2594779 · PMID 41320567
    Cited for: Finland
  21. Koskinen JP, Farkkila N, Sintonen H, Saarto T, Taari K, Roine RP. The association of financial difficulties and out-of-pocket payments with health-related quality of life among breast, prostate and colorectal cancer patients.
    Acta Oncologica. 2019;58:1062-1068.
    doi:10.1080/0284186X.2019.1592218 · PMID 30943813
    Cited for: Finland
  22. Lana AA, et al. Cost Analysis of Cancer in Brazil: A Population-Based Study of Patients Treated by Public Health System From 2001-2015.
    Value in Health Regional Issues (Value Health Reg Issues). 2020;23:137-147.
    doi:10.1016/j.vhri.2020.05.008 · PMID 33227545
    Cited for: Brazil
  23. Laudicella M, Walsh B, Burns E, Smith PC. Cost of care for cancer patients in England: evidence from population-based patient-level data.
    British Journal of Cancer. 2016;114:1286-92.
    doi:10.1038/bjc.2016.77 · PMID 27070711
    Cited for: United Kingdom
  24. Le NQ, Vo TQ, Doan TD. Analyzing the variation in treatment costs for colorectal cancer (CRC): A retrospective study to assess an underlying threat among the Vietnamese.
    J Pak Med Assoc. 2019;69(Suppl 2):S34-S40.
    PMID 31369532 · (no DOI assigned)
    Cited for: Vietnam
  25. Lee WR, et al. Disparities of health expenditure associated with the experience of admission in long-term care hospital among patients with colorectal cancer in South Korea: A generalized estimating equation.
    PLoS One. 2023;18:e0296170.
    doi:10.1371/journal.pone.0296170 · PMID 38127950
    Cited for: South Korea
  26. Leusder M, Relijveld S, et al. Toward value-based care using cost mining: cost aggregation and visualization across the entire colorectal cancer patient pathway.
    BMC Medical Research Methodology. 2024;24:321.
    doi:10.1186/s12874-024-02446-5 · PMID 39730997
    Cited for: Australia
  27. Longo CJ, et al. Patient and Family Financial Burden in Cancer: A Focus on Differences across Four Provinces, and Reduced Spending Including Decisions to Forego Care in Canada.
    Current Oncology (Curr Oncol). 2024;31:2713-2726 (issue 5).
    doi:10.3390/curroncol31050206 · PMID 38785487
    Cited for: Canada
  28. Mar J, Errasti J, Soto-Gordoa M, Mar-Barrutia G, Martinez-Llorente JM, Dominguez S, Garcia-Albas JJ, Arrospide A. The cost of colorectal cancer according to the TNM stage.
    Cirugia Espanola. 2017;95:89-96.
    doi:10.1016/j.ciresp.2017.01.001 · PMID 28189254
    Cited for: Spain
  29. Mariotto AB, Warren JL, Zeruto C, Coughlan D, Barrett MJ, Zhao L, Yabroff KR. Cancer-Attributable Medical Costs for Colorectal Cancer Patients by Phases of Care: What Is the Effect of a Prior Cancer History?.
    J Natl Cancer Inst Monogr. 2020;2020:22-30.
    doi:10.1093/jncimonographs/lgz032 · PMID 32412066
    Cited for: United States
  30. McGarvey N, et al. Out-of-pocket cost by cancer stage at diagnosis in commercially insured patients in the United States.
    J Med Econ. 2023;26:1318-1329.
    doi:10.1080/13696998.2023.2254649 · PMID 37907436
    Cited for: United States
  31. Mulder JMOK, et al. The burden of colorectal cancer survivors in the Netherlands: costs, utilities, and associated patient characteristics.
    Journal of Cancer Survivorship (J Cancer Surviv). 2021;16:1055-1064 (issue 5).
    doi:10.1007/s11764-021-01096-6 · PMID 34510364
    Cited for: Netherlands
  32. Nejati M, Razavi M, Harirchi I, Zanganeh M, Salari G, Tabatabaee SM. Resource Use and Costs Associated to the Initial Phase of Treatment for Patients with Colorectal Cancer Receiving Post-Surgery Chemotherapy: A Cost Analysis from a Healthcare Perspective.
    Iranian Journal of Public Health. 2021;50:1887-1896.
    doi:10.18502/ijph.v50i9.7062 · PMID 34722385
    Cited for: Iran
  33. Newton JC, Johnson CE, Hohnen H, Bulsara M, Ives A, McKiernan S, Platt V, McConigley R, Slavova-Azmanova NS, Saunders C. Out-of-pocket expenses experienced by rural Western Australians diagnosed with cancer.
    Support Care Cancer. 2018;26:3543-3552.
    doi:10.1007/s00520-018-4205-2 · PMID 29704109
    Cited for: Australia
  34. Nnene K, et al. Treatment cost of colon cancer at a South African tertiary academic hospital.
    J Cancer Policy. 2026;48:100725.
    doi:10.1016/j.jcpo.2026.100725 · PMID 41903647
    Cited for: South Africa
  35. Paszat L, Sutradhar R, et al. Overall Health Care Cost During the Year Following Diagnosis of Colorectal Cancer Stratified by History of Colorectal Evaluative Procedures.
    Journal of the Canadian Association of Gastroenterology. 2021;4:274-283.
    doi:10.1093/jcag/gwab001 · PMID 34877466
    Cited for: Canada
  36. Shi JF, et al. Clinical characteristics, medical service utilization, and expenditure for colorectal cancer in China, 2005 to 2014: Overall design and results from a multicenter retrospective epidemiologic survey.
    Cancer. 2021;127:1880-1893 (issue 11).
    doi:10.1002/cncr.33445 · PMID 33784413
    Cited for: China
  37. Sougklakos I, Athanasiadis E, Boukovinas I, Karamouzis M, Koutras A, Papakotoulas P, Latsou D, Hatzikou M, Stamuli E, Balasopoulos A, Sideris A. Treatment pathways and associated costs of metastatic colorectal cancer in Greece.
    Cost Eff Resour Alloc. 2022;20:7.
    doi:10.1186/s12962-022-00339-2 · PMID 35164784
    Cited for: Greece
  38. Utsumi T, Horimatsu T, Nishikawa Y, et al. Medical costs according to the stages of colorectal cancer: an analysis of health insurance claims in Hachioji, Japan.
    Journal of Gastroenterology. 2021;56:903-913.
    doi:10.1007/s00535-021-01798-9 · PMID 34215929
    Cited for: Japan
  39. Watanabe T, Goto R, Yamamoto Y, Ichinose Y, Higashi T. First-Year Healthcare Resource Utilization Costs of Five Major Cancers in Japan.
    Int J Environ Res Public Health. 2021;18:9447.
    doi:10.3390/ijerph18189447 · PMID 34574371
    Cited for: Japan
  40. Waye A, et al. Impact of the COVID-19 pandemic on mortality and treatment costs of patients with colorectal cancer.
    J Cancer Policy. 2025;44:100592.
    doi:10.1016/j.jcpo.2025.100592 · PMID 40328380
    Cited for: Canada
  41. Wuraola F, et al. The out-of-pocket cost of colorectal cancer care in Nigeria: A prospective analysis.
    Journal of Cancer Policy (J Cancer Policy). 2026;47:100705.
    doi:10.1016/j.jcpo.2026.100705 · PMID 41520785
    Cited for: Nigeria
  42. Yang O, Zhang Y, To YH, IJzerman MMJ, Liu J, Gibbs P, Trapani K, Pearson SA, Franchini F. Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysis.
    BMJ Open. 2024;14:e081483.
    doi:10.1136/bmjopen-2023-081483 · PMID 39653563
    Cited for: Australia
  43. Zheng Z, Yabroff KR, Guy GP, Han X, Li C, Banegas MP, Ekwueme DU, Jemal A. Annual Medical Expenditure and Productivity Loss Among Colorectal, Female Breast, and Prostate Cancer Survivors in the United States.
    J Natl Cancer Inst. 2016;108:djv382.
    doi:10.1093/jnci/djv382 · PMID 26705361
    Cited for: United States
  44. Ó Céilleachair A, et al. Counting the cost of cancer: out-of-pocket payments made by colorectal cancer survivors.
    Support Care Cancer. 2017;25:2733-2741.
    doi:10.1007/s00520-017-3683-y · PMID 28341973
    Cited for: Ireland

Full references for every observed cost study in the per-patient tool, with DOI/PMID. Countries without an observed study are extrapolated from income group and GDP (flagged in the data table) and are not listed here.

OncoSystems Hub · Independent, non-commercial · Produced within the Erasmus School of Health Policy & Management.