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Frontiers in Oncology
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Frontiers in Oncology
Article . 2025
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Clinical, humanistic and economic burden associated with recurrence among patients with early-stage cancers: a systematic literature review

Authors: Raquel Aguiar-Ibáñez; Yves P.V. Mbous; Sugandh Sharma; Evanka Chawla; Deepshikha Pawar;

Clinical, humanistic and economic burden associated with recurrence among patients with early-stage cancers: a systematic literature review

Abstract

IntroductionWhile cancer recurrences have been reported as negatively affecting patients’ prognosis and imposing an economic burden to healthcare systems, there is no comprehensive summary of evidence on how frequently recurrence occurs across early-stage cancers. The goal of this study was to assess recurrence rates and their resulting clinical, humanistic and economic burden in patients with early-stage cancers.MethodsA narrative, systematic literature review was conducted including non-interventional studies evaluating adult patients diagnosed with cancer at early-stages (including: melanoma, triple negative breast cancer, non-small cell lung cancer, renal-cell carcinoma, gastric cancer, head and neck cancer, and bladder cancer). Selected studies were identified through electronic database searches, conference proceedings, and grey literature sources. Outcomes of interest included recurrence rates, post-recurrence survival, and the humanistic and economic burden associated with recurrences.ResultsAmong 82 studies included, 75 reported recurrence rates, eight investigated post-recurrence survival, five evaluated post-recurrence patient-reported outcomes, and seven examined the post-recurrence economic burden. Across most cancer types, recurrences occurred frequently, with later stages at diagnosis being associated with higher recurrence rates and shorter time to recurrence compared to earlier stages at diagnosis. Cancer recurrence was associated with lower survival, reduced health-related quality of life (HRQoL), worsening cancer-related symptoms and higher healthcare resource utilization. These outcomes were also more pronounced among patients diagnosed at later stages. Among cancer survivors, most patients experienced moderate fear of cancer recurrence (FCR). Patients with clinically relevant FCR had worse cancer-related symptoms and reduced HRQoL compared to those without. Direct costs in recurrent patients (predominantly in the form of inpatient and outpatient costs) were the main drivers for the total healthcare costs incurred, irrespective of the cancer types and stages.ConclusionThis study highlights the high recurrence rates experienced by patients diagnosed with early-stage cancer, particularly if diagnosed at later stages (Stage III), and their clinical, humanistic and economic impact. Cancer stage at the time of diagnosis is a key indicator of recurrence risk and post-recurrence outcomes, emphasizing the importance of earlier diagnosis and the need for therapies that prevent recurrences to better mitigate their clinical, humanistic and economic burden.

Keywords

cancer recurrence, humanistic burden, Oncology, clinical burden, economic burden, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, cost of disease, survival, RC254-282

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    popularity
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    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Top 10%
Average
Average
Green
gold
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Cancer Research