Trends in 12-Month Mortality and Healthcare Costs in Incident Metastatic Colorectal Cancer in Germany, 2011–2024

Objective: To describe trends in age- and sex-standardized 12-month overall survival (OS) and inflation-adjusted costs among patients with incident metastatic colorectal cancer (mCC) in anonymized German statutory health insurance claims data from 2011 to 2024.

Methods: Patients with mCC were identified using ICD-10-GM diagnosis codes: C18–C20 (CC) and C77–C79 for metastatic disease. Metastatic disease was required to occur within ±3 months of the qualifying CC diagnosis, with no evidence of mCC during a 1-year baseline period. Age- and sex-standardized 12-month OS, standardized to the overall German statutory health insurance population, was assessed from the date of incident mCC (index date). Fourteen annual cohorts were defined according to index date year of each patient (2011–2024). Inflation-adjusted all-cause healthcare costs were measured over the 12-month post-index period for each patient and reported by index-year cohort. Trends in OS and costs were evaluated over time, using 2011 as the reference year.

Results: The cohort included 562 patients in 2011 and 328 in 2024; mean age was stable over time (67.4 vs 67.6 years), and approximately 41% were female. Standardized 12-month OS varied modestly across years, ranging from 80.7% to 86.7%, with no obvious improvement in recent years: OS was 82.1%/83.5% in patients with index years 2011/2012 and 84.9%/80.7% for 2023/2024. Costs increased moderately from €38,225 to €44,782 per patient (+17.2%). Costs excluding the final 4 weeks before death increased similarly, from €35,950 to €41,525 (+15.5%). Cost shares remained broadly similar over time, with inpatient care as the dominant component.