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.	董奧, 冉明, 張智月, 等. 癌癥化療患者經濟毒性、社會支持、生活質量現狀及其相關性. 現代臨床醫學, 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.	于慧會, 畢雪, 劉運泳. 中文版癌癥患者報告結局的經濟毒性量表信度和效度研究. 中華流行病學雜志, 2017, 38(8): 1118-1120.
11.	景靜鳳. 非轉移性乳腺癌患者經濟毒性調查及影響因素分析. 太原: 山西醫科大學, 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.	許可, 張楠, 劉金輝, 等. 肺癌患者經濟毒性及影響因素分析. 中華腫瘤防治雜志, 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.	袁靜, 林夢月, 楊斌, 等. 前列腺癌患者經濟毒性在自我效能與生活質量間的中介效應研究. 解放軍護理雜志, 2022, 39(1): 4-8.
16.	董奧, 姜玲, 王靜, 等. 癌癥化療患者經濟毒性水平及影響因素分析. 上海護理, 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, 湯利萍, 曹英, 等. 輸尿管皮膚造口患者經濟毒性狀況及影響因素分析. 護理學雜志, 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.	袁瀟逸, 孫艷玲, 況藝, 等. 乳腺癌生存者經濟毒性現狀與影響因素分析. 中國護理管理, 2022, 22(6): 830-835.
21.	董奧. 癌癥化療患者經濟毒性、社會支持與生活質量的相關性研究. 石河子: 石河子大學, 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.	孫艷玲, 況藝, 袁瀟逸, 等. 癌癥生存者經濟毒性現狀及影響因素. 護理學雜志, 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.	楊燕瀾, 劉泓妍, 李雪梅, 等. 白血病患兒經濟毒性現狀調查及其影響因素分析. 全科護理, 2023, 21(1): 117-120.
27.	周溢, 楊麗, 張妍欣, 等. 鼻咽癌幸存者經濟毒性現狀及影響因素分析. 軍事護理, 2023, 40(1): 15-18.
28.	孫蓓, 汪洋, 孫英明, 等. 按病種分值付費背景下乳腺癌日間化療患者經濟毒性預警模型的構建. 華西醫學, 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.	張江, 趙喜娟, 楊秉坤, 等. 肺癌放療患者經濟毒性現狀調查. 吉林醫學, 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, 蘇旺, 等. 癌癥患者經濟毒性影響因素和應對策略的系統評價. 中國實用護理雜志, 2023, 39(6): 450-457.
34.	蘇明珠. 基于患者報告結局的老年癌癥經濟毒性評估工具開發及初步驗證研究. 濟南: 山東大學, 2022.
35.	蔡玥, 嚴寶湖, 周恭偉. 2011-2015年中國肺癌直接經濟負擔及次均費用分析. 中國衛生統計, 2018, 35(3): 334-337.
36.	齊元濤, 柳言, 杜金, 等. 基于健康生態學模型的我國老年人慢性病共病影響因素研究. 中國全科醫學, 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. 董奧, 冉明, 張智月, 等. 癌癥化療患者經濟毒性、社會支持、生活質量現狀及其相關性. 現代臨床醫學, 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. 于慧會, 畢雪, 劉運泳. 中文版癌癥患者報告結局的經濟毒性量表信度和效度研究. 中華流行病學雜志, 2017, 38(8): 1118-1120.
11. 景靜鳳. 非轉移性乳腺癌患者經濟毒性調查及影響因素分析. 太原: 山西醫科大學, 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. 許可, 張楠, 劉金輝, 等. 肺癌患者經濟毒性及影響因素分析. 中華腫瘤防治雜志, 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. 袁靜, 林夢月, 楊斌, 等. 前列腺癌患者經濟毒性在自我效能與生活質量間的中介效應研究. 解放軍護理雜志, 2022, 39(1): 4-8.
16. 董奧, 姜玲, 王靜, 等. 癌癥化療患者經濟毒性水平及影響因素分析. 上海護理, 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, 湯利萍, 曹英, 等. 輸尿管皮膚造口患者經濟毒性狀況及影響因素分析. 護理學雜志, 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. 袁瀟逸, 孫艷玲, 況藝, 等. 乳腺癌生存者經濟毒性現狀與影響因素分析. 中國護理管理, 2022, 22(6): 830-835.
21. 董奧. 癌癥化療患者經濟毒性、社會支持與生活質量的相關性研究. 石河子: 石河子大學, 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. 孫艷玲, 況藝, 袁瀟逸, 等. 癌癥生存者經濟毒性現狀及影響因素. 護理學雜志, 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. 楊燕瀾, 劉泓妍, 李雪梅, 等. 白血病患兒經濟毒性現狀調查及其影響因素分析. 全科護理, 2023, 21(1): 117-120.
27. 周溢, 楊麗, 張妍欣, 等. 鼻咽癌幸存者經濟毒性現狀及影響因素分析. 軍事護理, 2023, 40(1): 15-18.
28. 孫蓓, 汪洋, 孫英明, 等. 按病種分值付費背景下乳腺癌日間化療患者經濟毒性預警模型的構建. 華西醫學, 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. 張江, 趙喜娟, 楊秉坤, 等. 肺癌放療患者經濟毒性現狀調查. 吉林醫學, 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, 蘇旺, 等. 癌癥患者經濟毒性影響因素和應對策略的系統評價. 中國實用護理雜志, 2023, 39(6): 450-457.
34. 蘇明珠. 基于患者報告結局的老年癌癥經濟毒性評估工具開發及初步驗證研究. 濟南: 山東大學, 2022.
35. 蔡玥, 嚴寶湖, 周恭偉. 2011-2015年中國肺癌直接經濟負擔及次均費用分析. 中國衛生統計, 2018, 35(3): 334-337.
36. 齊元濤, 柳言, 杜金, 等. 基于健康生態學模型的我國老年人慢性病共病影響因素研究. 中國全科醫學, 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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