Background: Cancer-related financial hardship is associated with poor care outcomes and reduced quality-of-life for patients and families. Scalable intervention development to address financial hardship requires knowledge of current screening practices and services within community cancer care. Materials and Methods:The National Cancer Institute's Community Oncology Research Program (NCORP) 2017 Landscape Assessment survey assessed financial screening and financial navigation practices within U.S. community oncology practices. Logistic models evaluated associations between financial hardship screening and availability of a cancer-specific financial navigator and practice group characteristics (e.g., safety-net designation, critical access hospital, proportion of racial and ethnic minority patients served).Results: Of 221 participating NCORP practice groups, 72% reported a financial screening process and 50% had a cancer-specific financial navigator. Practice groups with more than 10% of new cancer patients enrolled in Medicaid ( adj OR = 2.81, p = .02) and with less than 30% racial/ ethnic minority cancer patient composition ( adj OR = 3.91, p <.01) were more likely to screen for financial concerns. Practice groups with less than 30% racial/ethnic minority cancer patient composition ( adj OR = 2.37, p <.01) were more likely to have a dedicated financial navigator or counselor for cancer patients. Conclusions:Most NCORP practice groups screen for financial concerns and half have a cancer-specific financial navigator. Practices serving more racial or ethnic minority patients are less likely to screen and have a designated financial navigator.

The cost of cancer care is rising and represents a stressor that has significant and lasting effects on quality of life for many patients and caregivers. Adolescents and young adults (AYAs) with cancer are particularly vulnerable. Financial burden measures exist but have varying evidence for their validity and reliability. The goal of this systematic review is to summarize and evaluate measures of financial burden in cancer and describe their potential utility among AYAs and their caregivers. To this end, the authors searched PubMed, Embase, the Cochrane Library, CINAHL, and PsycINFO for concepts involving financial burden, cancer, and self‐reported questionnaires and limited the results to the English language. They discarded meeting abstracts, editorials, letters, and case reports. The authors used standard screening and evaluation procedures for selecting and coding studies, including consensus‐based standards for documenting measurement properties and study quality. In all, they screened 7250 abstracts and 720 full‐text articles to identify relevant articles on financial burden. Eighty‐six articles met the inclusion criteria. Data extraction revealed 64 unique measures for assessing financial burden across material, psychosocial, or behavioral domains. One measure was developed specifically for AYAs, and none were developed for their caregivers. The psychometric evidence and study qualities revealed mixed evidence of methodological rigor. In conclusion, several measures assess the financial burden of cancer. Measures were primarily designed and evaluated in adult patient populations with little focus on AYAs or caregivers despite their increased risk of financial burden. These findings highlight opportunities to adapt and test existing measures of financial burden for AYAs and their caregivers.

No abstract

No abstract