Screening for Financial Toxicity Among Patients With Cancer: A Systematic Review

Area of Science:

• Oncology
• Health Services Research
• Health Economics

Background:

• Financial toxicity (FT) significantly impacts cancer patients' well-being.
• Current clinical practices lack standardized methods for FT screening.
• The escalating cost of cancer care necessitates effective financial burden assessment.

Purpose of the Study:

• To systematically review current methods for assessing financial toxicity in cancer patients.
• To identify factors associated with an increased risk of financial toxicity.
• To evaluate the heterogeneity of FT screening practices in the United States.

Main Methods:

• Systematic review adhering to PRISMA guidelines.
• Inclusion of peer-reviewed studies measuring self-reported financial impact in US cancer patients.
• Analysis of screening timing, setting, tools, and associated patient-level factors.

Main Results:

• 51 studies met inclusion criteria, revealing wide variability in FT screening.
• Screening practices differ in timing, setting, tools used (7 validated), and interpretation cutoffs.
• Factors linked to higher FT include younger age, lower socioeconomic status, non-White race, advanced stage, and specific therapies.

Conclusions:

• Financial toxicity screening in the US is currently heterogeneous.
• Routine and universal FT screening is crucial given its link to adverse patient outcomes.
• Further research is needed to establish best practices and develop multifaceted interventions for FT screening.