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A Systematic Review of the Economic Burden of Prostate Cancer: Direct and Indirect Cost Perspectives

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Introduction Prostate cancer (PC) is the second most common cancer in men. Although many studies have assessed its
economic burden, no recent reviews have focused on studies conducted under current clinical guidelines. This study systematically reviews recent cost-of-illness studies evaluating direct and indirect costs associated with PC.
Methods A systematic search was conducted using the PICOS framework and a combination of free-text and MeSH terms
in PubMed and the Cochrane Library, and only free-text terms in EconLit. The search included articles published between
January 2015 and October 2025. Data on total, direct, and indirect costs were extracted and synthesized. All costs were
converted to 2025 USD, and quality of studies was assessed with a simplified version of the CHEERS checklist.
Results Ninety-five studies met the inclusion criteria. Direct medical costs for non-metastatic prostate cancer (nmPC) varied
widely by disease stage, treatment, and country, ranging from approximately US$1200 to US$280,000 per patient-year, with
higher costs observed in advanced stages and in patients experiencing treatment-related adverse events (AEs). Progression
to metastatic disease was associated with a marked cost escalation, with annual costs largely driven by systemic therapies
and skeletal-related events. Indirect costs ranged from US$666 to US$12,900 per patient-year and accounted for up to 30%
of total PC-related costs, primarily due to productivity losses from premature mortality.
Conclusions PC imposes a substantial economic burden on healthcare systems and society, particularly in advanced stages.
Policy promoting early detection, risk-adapted treatment, and equitable therapy access may help contain costs. Further
research should address the economic impact of emerging diagnostics and minimally invasive interventions.

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Articles publicats en revistes (Economia)

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A Systematic Review of the Economic Burden of Prostate Cancer: Direct and Indirect Cost Perspectives