Clinical, Humanistic, and Economic Benefits of Early Cancer Diagnosis: A Systematic Literature Review

OBJECTIVES:

The early diagnosis of cancer impacts treatment decisions and potentially improves survival and health-related-quality-of-life (HRQoL) outcomes, reducing the financial burden associated with later cancer stages. A narrative systematic review was conducted to understand the value of early cancer diagnosis from the clinical, humanistic and economic perspectives.

METHODS:

A literature search was conducted in Embase® and MEDLINE® (up to August 2022) to identify non-interventional studies reporting survival, HRQoL and the economic impact (i.e. direct and indirect costs) of diagnosing patients at earlier versus later stages of cancer. Patients with the following types of tumours were included: melanoma, triple negative breast cancer (TNBC), non-small cell lung cancer (NSCLC), renal-cell carcinoma (RCC), gastric cancer, head and neck cancer and bladder cancer.

RESULTS:

Overall, 111 studies were included, reporting clinical, humanistic and economic outcomes. Increased survival was observed among patients diagnosed with early stages, and within the less severe subgroup stages, compared to later stages/substages across all tumour types with sufficient evidence (i.e. NSCLC, melanoma, TNBC and bladder cancer). Among patients with NSCLC, the median OS range was 37.28-72 months for stage I and decreased to 2.8-13.8 months for stage IV. For patients with melanoma, the median OS range was 29.5-34 months for Stage IA/IB, decreasing to 5.1 months for Stage IV M1C. Patients with bladder cancer diagnosed at higher stages had decreased HRQoL. Patients diagnosed at advanced stages incurred in higher management costs. Among patients diagnosed with stages I to IV NSCLC, the per-patient per-month mean total healthcare cost ranged from US$7,239 to US$21,441, respectively, during 2007-2011. The mean cost per-patient-per-month was US$4,810 for patients with stage III TNBC and US$9,159 for patients with stage IV TNBC in 2013.

CONCLUSIONS:

Patients diagnosed with cancer at earlier stages had better survival and HRQoL, and decreased health-care costs, compared to patients diagnosed at later stages.