The prevalence of financial toxicity based on comprehensive scores for financial toxicity in Chinese cancer patients: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Li ^1,2,3 ,  SU Mingzhu ^2,3,4 , ZHANG Jinxin ^2,3,4 , FENG Yujia ^2,3,4

1. Cardiac Surgery Intensive Care Unit of Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, P. R. China;
2. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, P. R. China;
3. NHC Key Lab of Health Economics and Policy Research, Jinan 250012, P. R. China;
4. Center for Cancer Control and Policy Research (Shandong University), Jinan 250012, P. R. China;

Corresponding author：

SU Mingzhu, Email: sumingzhu@ sdu.edu.cn

Keywords：

China; Cancer patients; Financial toxicity; Meta-analysis

DOI：

10.7507/1672-2531.202306083

Video：

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Objective To systematically review the incidence of financial toxicity among cancer patients in China. Methods The Cochrane Library, Web of Science, PubMed, Embase, CINAHL, CNKI, and WanFang databases were searched to collect studies on the prevalence of financial toxicity among cancer patients in China from January 2016 to April 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. A meta-analysis was performed by using Stata 16.0 software. Results A total of 24 studies involving 8 799 participants were included. Meta-analysis results showed that the prevalence of financial toxicity among cancer patients was 67.4% (95%CI 60.9% to 74.0%) in China. The subgroup analysis showed that sex, educational level, type of medical insurance, cancer site and stage, the cut-off of the instrument, and region were all influential factors of financial toxicity among cancer patients. Conclusion Current evidence shows that high prevalence of financial toxicity among cancer patients. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： LIU Li, SU Mingzhu, ZHANG Jinxin, FENG Yujia. The prevalence of financial toxicity based on comprehensive scores for financial toxicity in Chinese cancer patients: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(11): 1269-1274. doi: 10.7507/1672-2531.202306083 Copy

1.	Su M, Yao N, Liu L, et al. Older cancer survivors living with financial hardship in China: a qualitative study of family perspectives. Psychooncology, 2022, 31(4): 661-670.
2.	Liu L, Cao Y, Su M, et al. Financial toxicity among older cancer survivors in China: a qualitative study of oncology providers' perceptions and practices. Support Care Cancer, 2022, 30(11): 9433-9440.
3.	Zafar SY, Peppercorn JM, Schrag D, et al. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience. Oncologist, 2013, 18(4): 381-390.
4.	Lentz R, Benson AB, Kircher S. Financial toxicity in cancer care: prevalence, causes, consequences, and reduction strategies. J Surg Oncol, 2019, 120(1): 85-92.
5.	Zhu Z, Xing W, Zhang X, et al. Cancer survivors' experiences with financial toxicity: a systematic review and meta-synthesis of qualitative studies. Psychooncology, 2020, 29(6): 945-959.
6.	Choi M, Lee EH, Sempungu JK, et al. Financial hardship, depression, and self-esteem: temporal analysis using a Korean panel study. Psychiatry Investig, 2023, 20(1): 35-42.
7.	Xu RH, Wang LL, Zhou LM, et al. Urban-rural differences in financial toxicity and its effect on cancer survivors' health-related quality of life and emotional status: a latent class analysis. Support Care Cancer, 2022, 30(5): 4219-4229.
8.	董奥, 冉明, 张智月, 等. 癌症化疗患者经济毒性、社会支持、生活质量现状及其相关性. 现代临床医学, 2022, 48(6): 404-407,415.
9.	de Souza JA, Yap BJ, Hlubocky FJ, et al. The development of a financial toxicity patient-reported outcome in cancer: the COST measure. Cancer, 2014, 120(20): 3245-3253.
10.	于慧会, 毕雪, 刘运泳. 中文版癌症患者报告结局的经济毒性量表信度和效度研究. 中华流行病学杂志, 2017, 38(8): 1118-1120.
11.	景静凤. 非转移性乳腺癌患者经济毒性调查及影响因素分析. 太原: 山西医科大学, 2020.
12.	Yu HH, Yu ZF, Li H, et al. The comprehensive score for financial toxicity in China: validation and responsiveness. J Pain Symptom Manage, 2021, 61(6): 1297-1304.
13.	许可, 张楠, 刘金辉, 等. 肺癌患者经济毒性及影响因素分析. 中华肿瘤防治杂志, 2021, 28(20): 1578-1582.
14.	Ng MSN, Choi KC, Chan DNS, et al. Identifying a cut-off score for the COST measure to indicate high financial toxicity and low quality of life among cancer patients. Support Care Cancer, 2021, 29(10): 6109-6117.
15.	袁静, 林梦月, 杨斌, 等. 前列腺癌患者经济毒性在自我效能与生活质量间的中介效应研究. 解放军护理杂志, 2022, 39(1): 4-8.
16.	董奥, 姜玲, 王静, 等. 癌症化疗患者经济毒性水平及影响因素分析. 上海护理, 2022, 22(5): 27-31.
17.	Xu T, Xu L, Xi H, et al. Assessment of financial toxicity among patients with advanced lung cancer in western China. Front Public Health, 2022, 9: 754199.
18.	沈雅琳, 汤利萍, 曹英, 等. 输尿管皮肤造口患者经济毒性状况及影响因素分析. 护理学杂志, 2022, 37(10): 26-29.
19.	Jiang H, Mou W, Lyu J, et al. Assessment of self-reported financial toxicity among patients with nasopharyngeal carcinoma undergoing radiotherapy: a cross-sectional study in western China. Front Oncol, 2022, 12: 1011052.
20.	袁潇逸, 孙艳玲, 况艺, 等. 乳腺癌生存者经济毒性现状与影响因素分析. 中国护理管理, 2022, 22(6): 830-835.
21.	董奥. 癌症化疗患者经济毒性、社会支持与生活质量的相关性研究. 石河子: 石河子大学, 2022.
22.	Yu H, Li H, Zuo T, et al. Financial toxicity and psychological distress in adults with cancer: a treatment-based analysis. Asia Pac J Oncol Nurs, 2022, 9(9): 100069.
23.	孙艳玲, 况艺, 袁潇逸, 等. 癌症生存者经济毒性现状及影响因素. 护理学杂志, 2022, 37(15): 24-27,31.
24.	Liu M, Huang D, Liu Y. Financial toxicity of patients with lung cancer in China: results from a national survey study. Cancer Med, 2023, 12(4): 4751-4760.
25.	Liu M, Hu L, Han X, et al. Financial toxicity in female patients with breast cancer: a national cross-sectional study in China. Support Care Cancer, 2022, 30(10): 8231-8240.
26.	杨燕澜, 刘泓妍, 李雪梅, 等. 白血病患儿经济毒性现状调查及其影响因素分析. 全科护理, 2023, 21(1): 117-120.
27.	周溢, 杨丽, 张妍欣, 等. 鼻咽癌幸存者经济毒性现状及影响因素分析. 军事护理, 2023, 40(1): 15-18.
28.	孙蓓, 汪洋, 孙英明, 等. 按病种分值付费背景下乳腺癌日间化疗患者经济毒性预警模型的构建. 华西医学, 2023, 38(2): 226-232.
29.	Chen Y, Chen Z, Jin H, et al. Associations of financial toxicity with symptoms and unplanned healthcare utilization among cancer patients taking oral chemotherapy at home: a prospective observational study. BMC Cancer, 2023, 23(1): 140.
30.	张江, 赵喜娟, 杨秉坤, 等. 肺癌放疗患者经济毒性现状调查. 吉林医学, 2023, 44(4): 1062-1068.
31.	Mo M, Jia P, Zhu K, et al. Financial toxicity following surgical treatment for colorectal cancer: a cross-sectional study. Support Care Cancer, 2023, 31(2): 110.
32.	Qiu Z, Yao L, Jiang J. Financial toxicity assessment and associated factors analysis of patients with cancer in China. Support Care Cancer, 2023, 31(5): 264.
33.	李小萱, 李佳蓉, 苏旺, 等. 癌症患者经济毒性影响因素和应对策略的系统评价. 中国实用护理杂志, 2023, 39(6): 450-457.
34.	苏明珠. 基于患者报告结局的老年癌症经济毒性评估工具开发及初步验证研究. 济南: 山东大学, 2022.
35.	蔡玥, 严宝湖, 周恭伟. 2011-2015年中国肺癌直接经济负担及次均费用分析. 中国卫生统计, 2018, 35(3): 334-337.
36.	齐元涛, 柳言, 杜金, 等. 基于健康生态学模型的我国老年人慢性病共病影响因素研究. 中国全科医学, 2023, 26(1): 50-57.

1. Su M, Yao N, Liu L, et al. Older cancer survivors living with financial hardship in China: a qualitative study of family perspectives. Psychooncology, 2022, 31(4): 661-670.
2. Liu L, Cao Y, Su M, et al. Financial toxicity among older cancer survivors in China: a qualitative study of oncology providers' perceptions and practices. Support Care Cancer, 2022, 30(11): 9433-9440.
3. Zafar SY, Peppercorn JM, Schrag D, et al. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience. Oncologist, 2013, 18(4): 381-390.
4. Lentz R, Benson AB, Kircher S. Financial toxicity in cancer care: prevalence, causes, consequences, and reduction strategies. J Surg Oncol, 2019, 120(1): 85-92.
5. Zhu Z, Xing W, Zhang X, et al. Cancer survivors' experiences with financial toxicity: a systematic review and meta-synthesis of qualitative studies. Psychooncology, 2020, 29(6): 945-959.
6. Choi M, Lee EH, Sempungu JK, et al. Financial hardship, depression, and self-esteem: temporal analysis using a Korean panel study. Psychiatry Investig, 2023, 20(1): 35-42.
7. Xu RH, Wang LL, Zhou LM, et al. Urban-rural differences in financial toxicity and its effect on cancer survivors' health-related quality of life and emotional status: a latent class analysis. Support Care Cancer, 2022, 30(5): 4219-4229.
8. 董奥, 冉明, 张智月, 等. 癌症化疗患者经济毒性、社会支持、生活质量现状及其相关性. 现代临床医学, 2022, 48(6): 404-407,415.
9. de Souza JA, Yap BJ, Hlubocky FJ, et al. The development of a financial toxicity patient-reported outcome in cancer: the COST measure. Cancer, 2014, 120(20): 3245-3253.
10. 于慧会, 毕雪, 刘运泳. 中文版癌症患者报告结局的经济毒性量表信度和效度研究. 中华流行病学杂志, 2017, 38(8): 1118-1120.
11. 景静凤. 非转移性乳腺癌患者经济毒性调查及影响因素分析. 太原: 山西医科大学, 2020.
12. Yu HH, Yu ZF, Li H, et al. The comprehensive score for financial toxicity in China: validation and responsiveness. J Pain Symptom Manage, 2021, 61(6): 1297-1304.
13. 许可, 张楠, 刘金辉, 等. 肺癌患者经济毒性及影响因素分析. 中华肿瘤防治杂志, 2021, 28(20): 1578-1582.
14. Ng MSN, Choi KC, Chan DNS, et al. Identifying a cut-off score for the COST measure to indicate high financial toxicity and low quality of life among cancer patients. Support Care Cancer, 2021, 29(10): 6109-6117.
15. 袁静, 林梦月, 杨斌, 等. 前列腺癌患者经济毒性在自我效能与生活质量间的中介效应研究. 解放军护理杂志, 2022, 39(1): 4-8.
16. 董奥, 姜玲, 王静, 等. 癌症化疗患者经济毒性水平及影响因素分析. 上海护理, 2022, 22(5): 27-31.
17. Xu T, Xu L, Xi H, et al. Assessment of financial toxicity among patients with advanced lung cancer in western China. Front Public Health, 2022, 9: 754199.
18. 沈雅琳, 汤利萍, 曹英, 等. 输尿管皮肤造口患者经济毒性状况及影响因素分析. 护理学杂志, 2022, 37(10): 26-29.
19. Jiang H, Mou W, Lyu J, et al. Assessment of self-reported financial toxicity among patients with nasopharyngeal carcinoma undergoing radiotherapy: a cross-sectional study in western China. Front Oncol, 2022, 12: 1011052.
20. 袁潇逸, 孙艳玲, 况艺, 等. 乳腺癌生存者经济毒性现状与影响因素分析. 中国护理管理, 2022, 22(6): 830-835.
21. 董奥. 癌症化疗患者经济毒性、社会支持与生活质量的相关性研究. 石河子: 石河子大学, 2022.
22. Yu H, Li H, Zuo T, et al. Financial toxicity and psychological distress in adults with cancer: a treatment-based analysis. Asia Pac J Oncol Nurs, 2022, 9(9): 100069.
23. 孙艳玲, 况艺, 袁潇逸, 等. 癌症生存者经济毒性现状及影响因素. 护理学杂志, 2022, 37(15): 24-27,31.
24. Liu M, Huang D, Liu Y. Financial toxicity of patients with lung cancer in China: results from a national survey study. Cancer Med, 2023, 12(4): 4751-4760.
25. Liu M, Hu L, Han X, et al. Financial toxicity in female patients with breast cancer: a national cross-sectional study in China. Support Care Cancer, 2022, 30(10): 8231-8240.
26. 杨燕澜, 刘泓妍, 李雪梅, 等. 白血病患儿经济毒性现状调查及其影响因素分析. 全科护理, 2023, 21(1): 117-120.
27. 周溢, 杨丽, 张妍欣, 等. 鼻咽癌幸存者经济毒性现状及影响因素分析. 军事护理, 2023, 40(1): 15-18.
28. 孙蓓, 汪洋, 孙英明, 等. 按病种分值付费背景下乳腺癌日间化疗患者经济毒性预警模型的构建. 华西医学, 2023, 38(2): 226-232.
29. Chen Y, Chen Z, Jin H, et al. Associations of financial toxicity with symptoms and unplanned healthcare utilization among cancer patients taking oral chemotherapy at home: a prospective observational study. BMC Cancer, 2023, 23(1): 140.
30. 张江, 赵喜娟, 杨秉坤, 等. 肺癌放疗患者经济毒性现状调查. 吉林医学, 2023, 44(4): 1062-1068.
31. Mo M, Jia P, Zhu K, et al. Financial toxicity following surgical treatment for colorectal cancer: a cross-sectional study. Support Care Cancer, 2023, 31(2): 110.
32. Qiu Z, Yao L, Jiang J. Financial toxicity assessment and associated factors analysis of patients with cancer in China. Support Care Cancer, 2023, 31(5): 264.
33. 李小萱, 李佳蓉, 苏旺, 等. 癌症患者经济毒性影响因素和应对策略的系统评价. 中国实用护理杂志, 2023, 39(6): 450-457.
34. 苏明珠. 基于患者报告结局的老年癌症经济毒性评估工具开发及初步验证研究. 济南: 山东大学, 2022.
35. 蔡玥, 严宝湖, 周恭伟. 2011-2015年中国肺癌直接经济负担及次均费用分析. 中国卫生统计, 2018, 35(3): 334-337.
36. 齐元涛, 柳言, 杜金, 等. 基于健康生态学模型的我国老年人慢性病共病影响因素研究. 中国全科医学, 2023, 26(1): 50-57.

Chinese Journal of Evidence-Based Medicine

The prevalence of financial toxicity based on comprehensive scores for financial toxicity in Chinese cancer patients: a meta-analysis

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