ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2021
Assessing the financial toxicity in Tunisian cancer patients using the Comprehensive Score for Financial Toxicity (COST).
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Assessing Financial Toxicity in Cancer: A Global Systematic Review and Meta-Analysis Using an Asset Framework.Cancer medicine · 2026Pooled it
- Measuring the Socioeconomic Impact of Cancer: A Systematic Review and Standardized Assessment of Patient-Reported Outcomes (PRO) Instruments.PharmacoEconomics - open · 2025Pooled it
- Evaluation of financial toxicity and associated factors in female patients with breast cancer: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Pooled it
- Reply to: Letter to the Editor Concerning "Financial Toxicity Among Survivors of Extremity and Pelvic Sarcoma: A Retrospective Study".Annals of surgical oncology · 2026Article
- Financial toxicity and psychosocial distress of breast and cervical cancer patients at a tertiary healthcare facility in south-western Nigeria.BMC women's health · 2026Article
- Female breast cancer burden among adolescent and young adults in North Africa.Breast cancer (Tokyo, Japan) · 2025Article
- The financial toll of cancer: uncovering the links between financial toxicity and symptom burden.The oncologist · 2025Observational
- Financial toxicity and associated factors among cancer patients attending public hospitals in Ethiopia.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Exploring financial toxicity and its impact on health-related quality of life of cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Assessment of the financial toxicity in patients with differentiated thyroid cancer: a cross-sectional study in western China.Frontiers in public health · 2025Article
- Article
- Heterogeneity of financial toxicity and associated risk factors for older cancer survivors in China.iScience · 2023Article
- Financial toxicity assessment and associated factors analysis of patients with cancer in China.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- Observational
- Financial toxicity of patients with lung cancer in China: Results from a National Survey Study.Cancer medicine · 2023Article
- Patient-reported benefit from proposed interventions to reduce financial toxicity during cancer treatment.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
- Assessment of self-reported financial toxicity among patients with nasopharyngeal carcinoma undergoing radiotherapy: A cross-sectional study in western China.Frontiers in oncology · 2022Article
- Correlates of financial toxicity in adult cancer patients and their informal caregivers.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCancer care-related out-of-pocket expenses and financial toxicity (FT) are a rising burden for patients. We aimed to evaluate patient-reported FT and to identify relevant correlates within a Tunisian population.
methodsWe conducted a survey using the 11-item Comprehensive Score for Financial Toxicity (COST) that could range from 0 = high to 44 = low. FT was grade 0 if ≥ 26, grade 1 = (14-25), grade 2 = (1-13), and grade 3 = 0. Scores were collected along with data regarding patient medical/social features and out-of-pocket expenses. Univariate and multivariate analyses were performed to identify factors associated with higher financial burden.
resultsAmong the 179 participants, median COST score was 20.8 (Q1 17-Q3 24), with 80.4% of patients experiencing financial toxicity: grade 0 = 20%, grade 1 = 68.4%, grade 2 = 11.7%, grade 3 = 0%. Most patients (66.5%) used to work before cancer and 44.7% reported ceasing work because of cancer. The time to go to the hospital was > 30 min in 66.5% of cases. Unemployment, time to hospital > 30 min, ceasing work because of cancer, and expenses on non-chemotherapy drugs exceeding 70 dinars (25 US dollars) were mostly associated with higher FT on univariate analysis. Distance to hospital and ceasing work because of cancer were the single most significant factors in multivariate analysis.
conclusionsLosing work due to cancer and unequal distribution of health care particularly in cities with long travel times to the nearest hospital are the main sources of financial distress.
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