OBJECTIVES

: To review the currently available literature to understand the direct medical cost of treating RC and its main cost drivers

METHODS

A pragmatic literature review was conducted in PubMed for English language articles published between January 2013 and November 2018 containing MeSH terms of rectal cancer or rectal neoplasm and cost, economics, economic burden, financial burden or medical resource. Less informative document types (small case series, letters, commentaries, etc.) were excluded from the review.

RESULTS

A total of 352 articles were screened and 67 articles were included in the literature synthesis, out of which 68% of them were of studies conducted in Europe or North America, 31% in Asia and 1% in other countries. Surgery is the costliest intervention in the initial treatment of RC ($15,000 to $23,000 USD) followed by chemotherapy ($11,000 to $15,000 USD) and radiation (approximately $4,000 USD). In all major geographic regions studied, robotic surgery appears to be the costliest surgical modality. While the costs of treating metastatic disease ($51,000 to $86,000 USD) has been documented, there was no recent evidence on the cost associated with the diagnosis of RC or long-term treatment complications.

CONCLUSIONS

While the current evidence suggests that surgery is one of the main cost drivers of the initial treatment of RC and metastatic disease may cost two to four times the initial treatment cost. Additional research is needed to understand the cost associated with the diagnosis of rectal cancer and complications stemming from its treatments.