Cancers: What Are the Costs in Relation to Disability-Adjusted Life Years? A Systematic Review and Meta-Analysis.

Cancers currently represent a leading cause of morbidity and mortality, and precisely estimating their burden is crucial for evidence-based decision-making. This study aimed at understanding the average costs of cancer-related disability-adjusted life years (DALYs) and highlighting possible differences in economic estimates obtained with diverse approaches. We searched four scientific databases to identify all the primary literature simultaneously investigating cancer-related costs and DALYs. In view of the different methodologies, studies were divided into two groups: those estimating costs starting from DALYs, and those independently performing cost and DALY analyses. The latter were pooled to compute costs per disease-related DALY: meta-analytic syntheses were performed for total costs and indirect costs, and in relation to the corresponding gross domestic product (GDP) per capita. The quality of included studies was assessed through the Quality of Health Economic Studies instrument. Seven studies were selected. Total and indirect pooled costs per DALY were, respectively, USD 9150 (95% CI: 5560-15,050) and USD 3890 (95% CI: 2570-5880). Moreover, the cost per cancer-related DALY has been found to be, on average, 32% (95% CI: 24-42%) of the corresponding countries' GDP per capita. Costs calculated a priori from DALYs may lead to results widely different from those obtained after data retrieval and model building. Further research is needed to better estimate the economic burden of cancer in terms of costs and DALYs.