Evidence map›Paper›PMID 42697984›Full record

ArticleJournal of cancer survivorship : research and practice2026

Demystifying financial toxicity measures: semi-structured interviews comparing COST-FACIT and ENRICh among cancer survivors on targeted oral anticancer medications (TOAMs).

Lisa M Lowenstein, Maria P Bernal, Erik P Bergren, Taahir K Busaidy, Eden R Brauer, Patricia A Ganz, Grace L Smith, Ya-Chen Tina Shih

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Article in Journal of cancer survivorship : research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Lisa M LowensteinDepartment of Health Services Research, Unit 733, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. lmlowenstein@mdanderson.org.
Maria P BernalDepartment of Health Services Research, Unit 733, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Erik P BergrenDepartment of Health Services Research, Unit 733, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Taahir K BusaidyDepartment of Health Services Research, Unit 733, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Eden R BrauerThe University of California Los Angeles School of Nursing, Los Angeles, CA, USA.
Patricia A GanzDepartment of Health Policy and Management, Fielding School of Public Health, The University of California Los Angeles, Los Angeles, CA, USA.
Grace L SmithDepartment of Health Services Research, Unit 733, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Ya-Chen Tina ShihDepartment of Health Policy and Management, Fielding School of Public Health, The University of California Los Angeles, Los Angeles, CA, USA.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI DIANE BODURKA · 1985 to 2026
$290.8M
NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

purposeDespite increasing efforts to address financial toxicity among patients with cancer, approaches to best identify patients for targeted intervention remain unclear. We compared qualitative accounts of financial toxicity among patients receiving targeted oral anticancer medications (TOAMs) to their scores in two screening tools, the COmprehensive Score for financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT) and the Economic Strain and Resilience in Cancer (ENRICh).

methodsWe conducted mixed-methods analysis of adult patients at a comprehensive cancer center. Patients had confirmed cancer diagnoses and orders for TOAMs in the last 3 months. Participants completed surveys (n = 108), and a subset with COST-FACIT scores indicating financial toxicity participated in semi-structured interviews (n = 20). We applied the Framework Method to examine qualitative accounts and developed joint matrices to assess how well each measure identified financial toxicity.

resultsQualitative accounts highlighted two elements of financial toxicity: financial strain and financial worry. For participants with extreme accounts of financial strain and financial worry (n = 6), COST-FACIT and ENRICh scores indicated medium to high levels of financial toxicity. For the rest (n = 14), qualitative accounts of financial strain and financial worry were not completely captured by COST-FACIT and/or ENRICh.

conclusionOur findings suggest a single measure may not adequately identify financial toxicity and differentiate between strain and worry. A stepwise, wholistic approach may better identify and connect patients to appropriate resources. IMPLICATIONS FOR CANCER SURVIVORS: Interventions that address financial toxicity in this group may need to use more than one measure to identify and route patients to targeted intervention.

Indexed as

CancerFinancial toxicityMixed methods researchQualitative research

Identifiers

PMID42697984
PMCPMC13614440

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