Evidence map›Paper›PMID 32653957›Full record

SynthesisSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2020

Financial toxicity associated with a cancer diagnosis in publicly funded healthcare countries: a systematic review.

Christopher J Longo, Margaret I Fitch, Laura Banfield, Paul Hanly, K Robin Yabroff, Linda Sharp

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed, 5 pooled it
24.1field-weighted citation impact, top 1% of its field
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

79 citing papers in PubMed, 5 syntheses or guidelines pooled it, 126 citations in OpenAlex.

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  10. Sociodemographic Factors related to Financial Toxicity among Cancer Patients and Survivors:"The Second Cancer Patient Experience Survey" - A Nationwide Study in Japan.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
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19 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

6 authors at 5 institutions in 4 countries.

Christopher J LongoHealth Policy and Management, DeGroote School of Business, McMaster University, Hamilton, Ontario, Canada. cjlongo@mcmaster.ca.ORCID http://orcid.org/0000-0002-3801-485X
Margaret I FitchBloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Laura BanfieldHealth Sciences Library, McMaster University, Hamilton, Ontario, Canada.
Paul HanlyNational College of Ireland, Dublin, Ireland.
K Robin YabroffHealth Services Research, American Cancer Society, Atlanta, GA, USA.
Linda SharpPopulation Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK.
McMaster University · CAAmerican Cancer Society · USNational College of Ireland · IENewcastle University · GBUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFinancial toxicity related to cancer diagnosis and treatment is a common issue in developed countries. We seek to systematically summarize the extent of the issue in very high development index countries with publicly funded healthcare.

methodsWe identified articles published Jan 1, 2005, to March 7, 2019, describing financial burden/toxicity experienced by cancer patients and/or informal caregivers using OVID Medline Embase and PsychInfo, CINAHL, Business Source Complete, and EconLit databases. Only English language peer-reviewed full papers describing studies conducted in very high development index countries with predominantly publicly funded healthcare were eligible (excluded the USA). All stages of the review were evaluated in teams of two researchers excepting the final data extraction (CJL only).

resultsThe searches identified 7117 unique articles, 32 of which were eligible. Studies were undertaken in Canada, Australia, Ireland, UK, Germany, Denmark, Malaysia, Finland, France, South Korea, and the Netherlands. Eighteen studies reported patient/caregiver out-of-pocket costs (range US$17-US$506/month), 18 studies reported patient/caregiver lost income (range 17.6-67.3%), 14 studies reported patient/caregiver travel and accommodation costs (range US$8-US$393/month), and 6 studies reported financial stress (range 41-48%), strain (range 7-39%), or financial burden/distress/toxicity among patients/caregivers (range 22-27%). The majority of studies focused on patients, with some including caregivers. Financial toxicity was greater in those with early disease and/or more severe cancers.

conclusionsDespite government-funded universal public healthcare, financial toxicity is an issue for cancer patients and their families. Although levels of toxicity vary between countries, the findings suggest financial protection appears to be inadequate in many countries.

Indexed as

Financial StressHealth ExpendituresNeoplasmsCaregiversFemaleHumansIncomeMaleUniversal Health CareCancerFinancial burdenFinancial strainFinancial stressFinancial toxicityLost incomeOut-of-pocket costs

Identifiers

PMID32653957
OpenAlexW3041266957

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.