The psychosocial cost burden of cancer: A systematic literature review

Abstract

Background and Objective: Psychosocial costs, or quality of life costs, account for psychological distress, pain, suffering and other negative experiences associated with cancer. They contribute to the overall economic burden of cancer that patients experience. But this category of costs remains poorly understood. This hinders opportunities to make the best cancer control policy decisions. This study explored the psychosocial cost burden associated with cancer, how studies measure psychosocial costs and the impact of this burden. Methods: A systematic literature review of academic and grey literature published from 2008 to 2018 was conducted by searching electronic databases, guided by the Institute of Medicine's conceptualization of psychosocial burden. Results were analyzed using a narrative synthesis and a weighted proportion of populations affected was calculated. Study quality was assessed using the Ottawa-Newcastle instrument. Results: A total of 25 studies were included. There was variation in how psychosocial costs were conceptualized and an inconsistent approach to measurement. Most studies measured social dimensions and focused on the financial consequences of paying for care. Fewer studies assessed costs associated with the other domains of this burden, including psychological, physical, and spiritual dimensions. Fourty-four percent of cancer populations studied were impacted by psychosocial costs and this varied by disease site (38%-71%). Two studies monetized the psychosocial cost burden, estimating a lifetime cost per case ranging from CAD$427753 to CAD$528769. Studies were of varying quality; 60% of cross-sectional studies had a high risk of bias. Conclusions: Consistency in approach to measurement would help to elevate this issue for researchers and decision makers. At two-thirds of the total economic burden of cancer, economic evaluations should account for psychosocial costs to better inform decision-making. More support is needed to address the psychosocial cost burden faced by patients and their families.

The Psychosocial Burden of Families with Childhood Blood Cancer

“…Most of the above-mentioned studies are based on evidence from developed countries. This is consistent with a recent systematic review by Essue et al, who find that most studies are focused on the financial impact of cancer, and are based on adult populations, or are conducted in developed countries [ 8 ].…”

“…The impact on any of these dimensions has the potential to interact and compound, further affecting relationships and dynamics within the household [ 24 ]. Most evidence on psychosocial costs focuses on the patient [ 8 ], or on the impact on parents [ 15 , 25 , 26 ]. We aim to provide a more general overview of the effect on families.…”

“…The treatment of children with cancer is expensive and resource intensive worldwide, and Chile is no exception [ 4 , 5 ]. However, the medical cost is not the only cost for families; several other associated costs contribute to the overall burden of cancer, namely, direct (e.g., medical care), indirect (loss of resources and opportunities), and psychosocial [ 6 , 7 , 8 , 9 ]. The latter encompasses intangible costs associated with cancer, such as pain and suffering, and the additional cost to individuals’ well-being [ 8 ].…”

Medical Cost of Cancer Care for Privately Insured Children in Chile

“…Finally, the medical cost was not the only cost faced by families with a child who had cancer. Several other associated costs contributed to the overall financial burden of cancer [4,17,50,51]. This subject will be studied in future research.…”

The Effect of Schema Therapy on Psychological Capital and Vulnerable Attachmenin Women with Breast Cancer

“…Optimism refers to positive causal attributions and how people explain positive and negative events and expect a positive outcome. Resilience refers to one's capacity to respond to their abilities to perform a particular task (13). Self-efficacy is a measure of one's confidence in their ability to perform a series of actions, which is associated with one's adaptation to cancer (14).…”