A major new study led by Health Data Insight CIC (HDI) Senior Health Data Analyst Clare Pearson has been published in Lancet Oncology, providing a detailed picture of how NHS hospital care costs vary by stage at cancer diagnosis in England.
The research, carried out by HDI in collaboration with NHS England’s National Disease Registration Service (NDRS) and colleagues at GRAIL Bio UK, analysed over 330,000 cancer cases diagnosed in people aged 50-79 between 2014 and 2017. Using linked national datasets, the team estimated long-term NHS hospital care costs for eight cancer types: colorectal, head and neck, liver and bile duct, lung, lymphoma, oesophageal, ovarian, and pancreatic cancer.
Why this study matters
Understanding the cost of cancer care is essential for assessing the value of early diagnosis and cancer prevention initiatives. However, robust, up-to-date cost estimates have been limited, particularly across a wide range of cancer types and over longer periods of patient follow-up. The study used a “net cost” approach, estimating cancer-related costs in line with National Institute for Health and Care Excellence (NICE) guidance.
Key findings
Costs varied by stage, but the pattern of this variation differed between cancer types.
For colorectal, head and neck, lymphoma, and ovarian cancer, later-stage diagnoses (stage III and IV) had higher hospital costs overall.
For liver, lung, oesophageal, and pancreatic cancer, costs were highest for stage II cancers, with slightly lower costs for stage III and IV cancers.
Initial treatment and end-of-life care were the costliest periods of care across all cancer types studied.
For cancers with poor short-term survival, such as lung, oesophageal, liver and pancreatic cancers, later-stage patients spent less time receiving hospital care due to high early mortality. This limited the total costs of care even though the average monthly costs were higher than for other stages of disease.
This is the first time long-term, stage-specific hospital care costs have been estimated for several of these cancer types in England. The methods developed by the team provide a framework for future cost analyses, particularly as new treatments and technologies continue to change cancer care.
The findings will help support economic evaluations of early detection approaches, including screening programmes and emerging diagnostic technologies, by providing detailed cost evidence from real-world NHS data.
See HDI Project: Costs of cancer by stage at diagnosis