Table 1 The prevalence of subjective financial toxicity in included studies
From: Subjective and objective financial toxicity among colorectal cancer patients: a systematic review
Author, Year | Country | Cancer stagea | Year of Research | Sample size | Prevalence of FTb (%) | Tools used |
|---|---|---|---|---|---|---|
Azzani et al. 2016 [17] | Malaysia | Stage I = VI | 2016 | 138 | 20.9% | 5-point Likert scale (‘very difficult’, ‘difficult’, ‘somewhat difficult’, ‘not that difficult’ or ‘not difficult at all’). A categorization was achieved according to the reporting of a difficult/very difficult (yes/no). |
Sharp et al. 2018 [29] | Europe | Stage I = VI | 2007–2009 | 493 | 41% had financial stress, 39% financial strain, 32% reported both financial stress and financial strain | 7 Likert scale more diff more concern to much less concern, collapse into more diff/concern, no change, less diff/concern financial stress was assessed as the impact of the cancer diagnosis on the household’s ability to make ends meet, financial strain as the impact on the individual (i.e. how the respondent had felt about their household’s financial situation since their cancer diagnosis). |
Edward et al. 2021 [19] | USA | Stage I = VI | 2019 | 104 | 80% had material burden and the mean COST was 24.5 | A material burden: total score was formed by summing seven indicator variables bankruptcy, borrowing money or going into debt, making financial sacrifices, being worried about having to pay large medical bills, being unable to cover treatment costs, and not being able to receive care because of costs. Psychological aspects: using the COST (COmprehensive Score for Financial Toxicity) questionnaire |
Gordon et al. 2017 [24] | Australia | Stage I = VI | Jan 2010 to Sep. 2011 | 187 | 1–0.6% answered as poor for 1st domain, financial strain reported by 15% and 7%, difficult to raise money 41% and 33% at 6 and 12 months, respectively | FT questionnaire of 3 domains: perceived prosperity (prosperous, very comfortable, reasonably comfortable, just getting along, or poor or very poor), financial strain (couldn’t pay utilities on time, couldn’t pay my mortgage or rent on time, sold something, went without a meal, unable to heat home, ask for financial help from friends or family, asked to financial help form organization) ability to raise money ($2000) (I could easily raise money, unable/difficult to raise money) |
Shankaran et al. 2012 [21] | USA | Stage III colon cancer | 2008–2010 | 284 | 71.3% | Major financial hardship (MFH) was defined as 1 or more of the following during the 12 months following enrolment: accumulating a debt of any amount, selling a home, refinancing a home, experiencing a higher than 20% income decline, or borrowing money from family and/or friends. |
Hanly et al. 2018 [28] | Ireland | Stage I-VI | 2010 | 496 | 40.9% experienced objective stress and 39.4% experienced subjective strain. | 7 Likert scale more diff more concern to much less concern, collapse into more diff/concern, no change, less diff/concern financial stress was assessed as the impact of the cancer diagnosis on the household’s ability to make ends meet, financial strain as the impact on the individual (i.e. how the respondent had felt about their household’s financial situation since their cancer diagnosis). |
Mo, M et al. 2023 [27] | China | Stage I = VI | 2022 | 250 | Median = 21, 52.8% had FT | COST (COmprehensive Score for financial Toxicity) questionnaire |
Regenbogen, Set al. 2014 [20] | USA | Stage III | 2011–2013 | 937 | No sum of score, the results compared the FT between those with complications and without it using the 7 items of FT and 2 items on worry and composite financial burden | The personal financial burden was evaluated using a seven-item checklist: “I had to use savings,” “I had to borrow money or take out a loan,” “I could not make payments on credit cards or other bills,” “I cut down on spending for food and/or clothes,” “I cut down on spending for health care for other family members,” “I cut down on recreational activities,” and “I cut down on expenses in general.” with higher scores denoting increased financial burden. The composite measure was: (“My illness has had no impact on my finances”) and a single question about financial worry (“How much do you worry about financial problems that have resulted from your colorectal cancer and its treatment?” Worry was evaluated on a 5-point Likert scale that we dichotomized by our previous work (in which scores of 1–3 were considered low, and scores of 4–5 were considered high) |
Huang et al. 2017 [25] | China | all stages | September 2012 to December 2014 | 2356 | 75.0% of the families perceive an unmanageable burden (47.4% heavy, 27.6% overwhelmed); only 18.3% perceived a somewhat manageable burden, and 6.7% perceived no burden at all. The | Questions were asked, “Which of the following accurately describes your family’s financial pressure from your disease?” and offered four response options: “not at all,” “somewhat but manageable,” “heavy,” and “overwhelmed.” We classified “not at all” and “somewhat but manageable” as manageable burdens; we classify |