OBJECTIVES: To perform a systematic review of the literature on the utility weights for colorectal cancer (CRC) health states; to determine the effects of study characteristics and role of “time to/from initial care” on utility values. METHODS: In a systematic review we identified 26 articles in English, providing 161 unique utilities for CRC health states elicited from 3574 respondents. Some utilities were estimated from SF-36 scores. Data were analyzed using Ordinary Least Squares and Linear Mixed- Effects with CRC cancer type, condition, stage, time to/from initial care, instrument, administration and study design as independent variables.   RESULTS: In the base model, the estimated utility of the reference case (scenario of a CRC patient on stage I-III in continues care and more than 1 year post-operation, rated by using EQ5D/HUI3) was 0.72. Cancer type, condition, stages, time to/from initial care, instruments and study design were associated with utility differences of 0.08 to 0.30 (P <0.05). Utilities derived by using EQ5D/HUI3 instrument were 0.09 lower than SG/TTO, 0.08 lower than EQ5Dvas and 0.09 lower than SF-36 (P <0.01) in the base model of OLS analysis. Those utilities differences were significantly larger in the supplemental model. Utilities elicited at “post-operation more than 1 year” were 0.15 higher than “preoperative”, 0.30 higher than “post-operation 1 year” in supplemental model. CONCLUSIONS: The CRC utilities review shows a lack of quality of life (QoL) studies for surveillance and terminal care that might cause high level uncertainty in the cost-effectiveness analysis results. Pre- and post-operative health states and time to/from health intervention are important factors that influence QoL. Utilities appear sensitive to factors such as cancer type, time to/from initial care and utility instruments.