OBJECTIVES: Health state utilities are commonly reported before and after disease progression following an intervention. Our objective was to describe the average health state utility values (HSUV) within stages by cancer type.

METHODS: A systematic literature review was conducted using Embase, MEDLINE®, and EconLit (January 1999-September 2019). Eligible studies included reported utilities for cancer stage based on indirect (eg, EQ-5D, SF-6D, HUI-3) or direct methods such as standard gamble (SG) or time trade-off (TTO).

RESULTS: From 13,872 publications, 27 were eligible and included for evidence synthesis. Studies were primarily conducted in China (n=4), South Korea (n=3), Japan (n=2), and the United States (n=2). Data sources were mainly from hospitals (eg, medical records or surveys). Breast cancer was most reported (n=9), followed by colorectal (n=4), non-small cell lung cancer (NSCLC) (n=3), and cervical cancer (n=3). EQ-5D was the most common assessment method (n=10), followed by SG (n=6), and TTO (n=5). Mean health utilities for early stage (0-II) breast cancer, colorectal cancer, NSCLC, and cervical cancer ranged from 0.54-0.90, 0.44-0.77, 0.38-0.84, and 0.50-0.85, respectively. Across cancer types, in studies reporting HSUV for multiple stages, disutility from stage I to II (n=7) ranged from -0.11 to 0.04; stage II to III (n=7) from -0.11 to -0.01; stage III to IV (n=7) from -0.37 to 0.06.

CONCLUSIONS: Although the evidence suggested that HSUV generally decreases with increased cancer stage, wide variations were observed among studies. This variation likely reflected differences in methods, social tariffs, geography, and disease-specific factors such as treatment status. This review provided health utility estimates across a range of cancer types and stages, but highlighted the care required when assessing HSUV across multiple studies.