OBJECTIVES: Esophageal cancer (EC) is the sixth most common cause of cancer-related mortality, contributing to significant economic burden for patients and caregivers. Cost of illness studies, which are useful tools for policymakers, vary in the burden reported due to methodological differences. This study aims to systematically summarize available evidence on the economic burden of EC and describes the methods and data sources utilized.

METHODS: A systematic review was independently conducted by two reviewers summarizing economic burden studies of EC using four electronic databases, Pubmed, EMBASE, EconLit, and CINAHL, from inception to December 28, 2022. Reference lists of eligible studies were screened to identify additional articles. Study methodology and cost components were extracted. Costs were reported in 2021 US dollars. Quality assessment was conducted using Larg and Moss checklist.

RESULTS: This review included 29 articles, considered to be of good quality. The studies were conducted across 11 countries in 5 continents and over 50% were from high-income countries. Most studies adopted a retrospective design (n=22; 75%) and a prevalence-based approach (n=19; 65%). Societal and payer perspectives were frequently utilized in the studies (n=10, 34%), but over half of the studies (n=16; 55%) did not clearly state the perspective. The human capital approach was used for studies that estimated indirect costs (n=8; 28%); however, many studies reported only direct medical costs of EC. In general, databases and literature were the most common data sources used. The total annual cost estimates reported for national studies ranged from US$6.64 million to US$10.48 billion. The economic burden of EC was estimated to range from <0.001% of the Gross Domestic Product in Brazil to 0.07% in Taiwan.

CONCLUSIONS: The review suggests that the economic burden of EC was underestimated. There is need to capture all relevant cost components, including indirect costs to accurately capture the economic burden of EC.