ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2021
Identifying a cut-off score for the COST measure to indicate high financial toxicity and low quality of life among cancer patients.
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 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Association between Financial Hardship and Symptom Burden in Patients Receiving Maintenance Dialysis: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Financial hardship among patients with lung cancer and their family caregivers: A comparative study of two institution-based samples from Hong Kong and Mainland China.Asia-Pacific journal of oncology nursing · 2026Article
- 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 in Neuromyelitis Optica Spectrum Disorder: An ABC-X Mixed-Methods Study.Brain and behavior · 2026Article
- Impacts of Financial Toxicity on Patients Receiving Dialysis: An Exploratory Qualitative Study.Kidney360 · 2026Article
- Financial toxicity and its association with quality of life and psychological distress among patients with gynecologic cancers receiving radiotherapy in China: a multicenter cross-sectional study.Frontiers in public health · 2026Article
- Disparities in cancer-related financial toxicity across economically diverse provinces in China: A multi-center cross-sectional study.Asia-Pacific journal of oncology nursing · 2025Article
- Financial Toxicity in ESKD.Kidney360 · 2025Article
- Relationship between Quality of Life and Suicide Risk in Iranian Cancer Patients: The Mediating Role of Religious Coping.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- Associations between financial toxicity, health-related quality of life, and well-being in Indonesian patients with breast cancer.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- 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
- Review
- Beyond Medical Bills: High Prevalence of Financial Toxicity and Diverse Management Strategies Among Vietnamese Patients With Cancer.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2024Article
- Financial Toxicity, Time Toxicity, and Quality of Life in Multiple Myeloma.Clinical lymphoma, myeloma & leukemia · 2024Article
- Financial Toxicity in Japanese Patients with Metastatic Renal Cell Carcinoma: A Cross-Sectional Study.Cancers · 2024Article
- Financial toxicity and its risk factors among patients with cancer in China: A nationwide multisite study.Asia-Pacific journal of oncology nursing · 2024Article
- Financial toxicity and patient experience associated with financial burden of molecular-targeted and immune therapies for cancer: an observational study under public health insurance.International journal of clinical oncology · 2024Observational
- Determination of a cut-off COmprehensive Score for financial Toxicity (COST) for identifying cost-related treatment nonadherence and impaired health-related quality of life among Chinese patients with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- A Financial Toxicity Screening and Care Coordination Quality Improvement Program in a Gynecology Oncology Urban Practice.Journal of the advanced practitioner in oncology · 2024Article
- Financial well-being as a mediator of the relationship between multimorbidity and health-related quality of life in people with cancer.Cancer medicine · 2023Article
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
Abstract
purposeTo identify a cut-off score for the COmprehensive Score for financial Toxicity (COST) to predict a clinical implication of a high level of financial toxicity (FT).
methodsA total of 640 cancer patients were recruited from three regional hospitals in Hong Kong. They completed a questionnaire comprising the COST measure and the Functional Assessment of Cancer Therapy - General (FACT-G) instrument. The cut-off score for the COST that predicts the lowest quartile of the FACT-G total score was identified by receiver operating characteristic (ROC) analysis. The sample was then stratified by this cut-off score, and characteristics were compared using Fisher's exact, chi-squared or independent sample t-test.
resultsThe mean scores were 20.1 ± 8.8 for the COST and 71.6 ± 15.5 for the FACT-G. The ROC analysis suggested that the cut-off of 17.5 yielded an acceptable sensitivity and specificity. Characteristics of patients with a higher level of FT included being younger, having a monthly household income of < 10,000 HKD (approximately 1290 USD), being more likely not employed, having stage IV cancer and receiving targeted and/or immunotherapy. In terms of financial support, a higher proportion of these patients had discussed financial issues with health care professionals and had received financial assistance. In addition, fewer of them were covered by private health insurance.
conclusionOur findings suggest a cut-off for the COST that can be used to screen for FT in clinical settings. In addition, while a considerable proportion of high-FT patients received targeted therapy, they often received financial assistance. There is a gap between financial hardship and assistance that warrants attention.
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