The Societal Burden of Breast Cancer in Working-Age Women in Croatia: A Multicentre Cross-Sectional Study

Breast cancer affects working-age women not only through treatment and survival but also through health-related quality of life (HRQoL), work capacity and informal caregiving needs. A total of 271 women participated (mean age 51.3 years among age-eligible records). Mean EQ-5D-5L utility was 0.76 versus 0.91 in the general population, corresponding to an annual QALY loss of 0.15 and a monetised HRQoL/welfare loss of €2550 per patient-year. Among employed participants, mean overall work productivity loss was 43.9% (842.9 h/year), equivalent to €7333 annually. Informal caregiving was reported by 54.7% of participants, with mean annual costs of €1566. Economic indirect costs were €8899 per patient-year. In an extended welfare-inclusive scenario, the estimated burden was €11,449 per patient-year, corresponding to an illustrative national estimate of €86 million (0.11% of gross domestic product). Breast cancer in working-age women imposes a substantial societal burden in Croatia, driven by reduced HRQoL, productivity losses and informal caregiving needs. These findings support taking societal burden into account in public health planning, survivorship care and health policy decision-making.