Evidence map›Paper›PMID 27798816›Full record

SynthesisThe patient2017

A Systematic Review of Financial Toxicity Among Cancer Survivors: We Can't Pay the Co-Pay.

Louisa G Gordon, Katharina M D Merollini, Anthony Lowe, Raymond J Chan

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The patient, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 256 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
256citing papers in PubMed, 16 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

256 citing papers in PubMed, 16 syntheses or guidelines pooled it.

  1. Pooled it
  2. Towards the assessment of financial distress among cancer patients: a conceptual model of the financial effects of a tumour disease.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
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  4. Guideline
  5. Methodologies and characteristics of studies investigating the cost of the palliative phase of cancer: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
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  14. Financial toxicity and employment status in cancer survivors. A systematic literature review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020
    Pooled it
  15. Pooled it
  16. Financial toxicity associated with a cancer diagnosis in publicly funded healthcare countries: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020
    Pooled it
  17. Sources of informal financial support among adolescent and young adult cancer survivors: a mixed methods analysis from the HIAYA CHAT study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Trial
  18. A randomised online experimental study to compare responses to brief and extended surveys of health-related quality of life and psychosocial outcomes among women with breast cancer.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2021
    Trial
  19. Article
  20. Adapting a Cancer Cost and Health Insurance Tool for Implementation: Rapid Qualitative Analysis.Health expectations : an international journal of public participation in health care and health policy · 2026
    Article

196 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Louisa G GordonPopulation Health, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, Brisbane, QLD, 4006, Australia. louisa.gordon@qimrberghofer.edu.au.
Katharina M D MerolliniFaculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore, Sunshine Coast, QLD, Australia.
Anthony LoweProstate Cancer Foundation of Australia, St Leonards, Sydney, NSW, Australia.
Raymond J ChanSchool of Nursing, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the extent of financial toxicity (FT) among cancer survivors, identify the determinants and how FT is measured.

methodsA systematic review was performed in MEDLINE, CINAHL and PsycINFO, using relevant terminology and included articles published from 1 January, 2013 to 30 June, 2016. We included observational studies where the primary outcomes included FT and study samples were greater than 200. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.

resultsFrom 417 citations, a total of 25 studies were included in this review. Seventy outcomes of FT were reported with 47 covering monetary, objective and subjective indicators of FT. A total of 28-48% of patients reported FT using monetary measures and 16-73% using subjective measures. The most commonly reported factors associated with FT were: being female, younger age, low income at baseline, adjuvant therapies and more recent diagnosis. Relative to non-cancer comparison groups, cancer survivors experienced significantly higher FT. Most studies were cross-sectional and causal inferences between FT and determinants were not possible. Measures of FT were varied and most were not validated, while monetary values of out-of-pocket expenses included different cost components across studies.

conclusionsA substantial proportion of cancer survivors experience financial hardship irrespective of how it is measured. Using standardised outcomes and longitudinal designs to measure FT would improve determination of the extent of FT. Further research is recommended on reduced work participation and income losses occurring concurrently with FT and on the impacts on treatment non-adherence.

Indexed as

Cancer SurvivorsCost SharingCross-Sectional StudiesFinancing, PersonalHealth ExpendituresHumans

Identifiers

PMID27798816

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.