Evidence map›Paper›PMID 34530765›Full record

SynthesisBMC cancer2021

Physician-patient communication of costs and financial burden of cancer and its treatment: a systematic review of clinical guidelines.

Anupriya Agarwal, Ann Livingstone, Deme J Karikios, Martin R Stockler, Philip J Beale, Rachael L Morton

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
6.8field-weighted citation impact, top 3% 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

27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
  2. Communication of costs and financial burdens between cancer patients and healthcare providers: a qualitative systematic review and meta-synthesis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Pooled it
  3. Article
  4. Article
  5. Persistent Financial Burden Among U.S. Cancer Survivors Despite Affordable Care Act Implementation: Implications for Survivorship Financial Education.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026
    Article
  6. Article
  7. Article
  8. Patient Preferences for Post-Radical Cystectomy Treatment in Muscle-Invasive Bladder Cancer: A Discrete Choice Experiment in Japan.International journal of urology : official journal of the Japanese Urological Association · 2025
    Article
  9. Article
  10. Article
  11. Review
  12. Cancer survivor preferences on the timing and content of interventions to mitigate financial toxicity associated with cancer treatment.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Article
  13. Article
  14. Article
  15. Review
  16. Review
  17. Article
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  19. Review
  20. Article
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 1 institution in 1 country.

Anupriya AgarwalNHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, 2050, Australia. anupriya.agarwal@sydney.edu.au.ORCID http://orcid.org/0000-0001-6111-8430
Ann LivingstoneNHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, 2050, Australia.
Deme J KarikiosNHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, 2050, Australia.
Martin R StocklerNHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, 2050, Australia.
Philip J BealeNHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, 2050, Australia.
Rachael L MortonNHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, 2050, Australia.
The University of Sydney · AU

Funding

Melanoma Institute Australia Postgraduate Research Supplementary ScholarshipNational Health and Medical Research Council (AU) PhD ScholarshipNational Health and Medical Research Council of Australia APP1150989National Health and Medical Reseearch Council of Australia APP1168194Sydney Catalyst Postgraduate Research Supplementary ScholarshipUniversity of Sydney Sydney Robinson Fellowship
6 · The paper itself

Abstract

backgroundOptimising the care of individuals with cancer without imposing significant financial burden related to their anticancer treatment is becoming increasingly difficult. The American Society of Clinical Oncology (ASCO) has recommended clinicians discuss costs of cancer care with patients to enhance shared decision-making. We sought information to guide oncologists' discussions with patients about these costs.

methodsWe searched Medline, EMBASE and clinical practice guideline databases from January 2009 to 1 June 2019 for recommendations about discussing the costs of care and financial burden. Guideline quality was assessed with the AGREE-II instrument.

resultsTwenty-seven guidelines met our eligibility criteria, including 16 from ASCO (59%). 21 of 27 (78%) guidelines included recommendations about discussion or consideration of treatment costs when prescribing, with information about actual costs in four (15%). Recognition of the risk of financial burden or financial toxicity was described in 81% (22/27) of guidelines. However, only nine guidelines (33%) included information about managing the financial burden.

conclusionsCurrent clinical practice guidelines have little information to guide physician-patient discussions about costs of anticancer treatment and management of financial burden. This limits patients' ability to control costs of treatment, and for the healthcare team to reduce the incidence and severity of financial burden. Current guidelines recommend clinician awareness of price variability and high costs of treatment. Clinicians are recommended to explore cost concerns and address financial worries, especially in high risk groups. Future guidelines should include advice on facilitating cost transparency discussions, with provision of cost information and resources.

Indexed as

CommunicationCost of IllnessOncologistsPhysician-Patient RelationsFinancial StressHealth Care CostsHumansNeoplasmsPractice Guidelines as TopicSocieties, Medicalcancer costsCost discussionsCosts of careFinancial burdenFinancial toxicityGuidelinesSystematic review

Identifiers

PMID34530765
PMCPMC8447743
OpenAlexW3200674453

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.