Comprehensive Score for Financial Toxicity and Health-Related Quality of Life in Patients With Cancer and Survivors: A Systematic Review and Meta-Analysis

Disparities in household material hardship, financial toxicity, and income loss in pediatric cancer

“… 1–8 These costs are associated with worse financial outcomes, but also psychological distress and inadequate access to care. Financial burden has been associated with reduced quality of life, poor family functioning, depression/anxiety, cognitive impairment, and sleep impairment 9–12 …”

“…Financial burden has been associated with reduced quality of life, poor family functioning, depression/anxiety, cognitive impairment, and sleep impairment. [9][10][11][12] We chose to investigate three measures of financial burden: household material hardship (HMH), financial toxicity, and income loss (Table S1). HMH is a particularly salient measure, because it has been associated with poor health outcomes, 13 increased emergency department utilization, and higher rates of hospitalization.…”

Financial toxicity in thyroid cancer survivors

“…Financial toxicity, defined as the combination of objective financial burden and psychological distress related to financial concerns, plays a significant role in the noted decrease in quality of life of cancer patients [5,6,[10][11][12][13][14]15 && , 16,17]. Patients with cancer are particularly vulnerable due to the substantial costs of treatment and surveillance [6,10,17-22,23 & ,24].…”

“…COST has allowed for many subjective analyses on the effects of financial burden on quality of life. These studies have established a connection between financial toxicity and health-related quality of life (HRQoL), including physical health, social health, mental health, and daily functioning [10][11][12][13][14]15 && ,30 -34]. Initial data showed race, employment status, income, number of inpatient admissions, and psychosocial distress were independent factors for financial toxicity.…”

“…Further, when controlling for other variables, the strongest predictor of a decrease in quality of life was the degree to which cancer caused financial problems [10]. Many subsequent studies have revealed younger age, female sex, lower income, and limited or no insurance coverage as the most prominent risk factors, with patients lacking insurance being at twice the risk for financial burden [6,10,12,14,15 ▪▪ ,16,17,20,22,23 ▪ ,24,25,28–31,35–45]. Additionally, patients with financial burden are over three times more likely to suffer from depression and psychological distress and are more likely to report poor physical health, mental health, and satisfaction with social activities and relationships than those with no financial hardship [13].…”