Financial toxicity: A practical review for gynecologic oncology teams to understand and address patient-level financial burdens Review


Authors: Liang, M. I.; Harrison, R.; Aviki, E. M.; Esselen, K. M.; Nitecki, R.; Meyer, L.
Review Title: Financial toxicity: A practical review for gynecologic oncology teams to understand and address patient-level financial burdens
Abstract: Financial toxicity describes the adverse impact patients experience from the monetary and time costs of cancer care. The financial burden patients experience comes from substantially increased out-of-pocket spending that often occurs concurrent with reduced income due to sick leave from work. Financial toxicity is common affecting approximately half of patients with a gynecological cancer depending on the validated instrument used for measurement. Financial toxicity is experienced by patients in three domains: economic hardship affecting patients' material conditions (i.e., medical debt), psychological response (i.e., distress), and health-related coping behaviors that patients adopt (i.e., foregoing care due to costs). Higher financial toxicity among cancer patients has been associated with decreased quality of life, impaired adherence to recommended care, and worse overall survival. In this review, we describe the current literature on financial toxicity, including how it can be assessed with validated tools, the downstream impact on patients, risk factors, and employment concerns of survivors. Whenever possible, we highlight data from research featuring patients with gynecologic cancer specifically. We also review studies with interventions aimed to mitigate financial toxicity and offer the reader real world examples of interventions currently being used. Lastly, we provide an overview of health policy developments relevant to financial toxicity and advocate for innovation in the development and implementation of strategies to decrease the financial toxicity patients experience following a diagnosis of gynecologic cancer. © 2023 Elsevier Inc.
Keywords: adult; cancer survival; clinical article; overall survival; review; case report; cancer patient; quality of life; survivor; risk assessment; health care policy; financial management; distress syndrome; coping behavior; gynecologic cancer; female genital tract cancer; employment; human; female; patient risk; financial toxicity; financial distress; financial navigation; costs of care
Journal Title: Gynecologic Oncology
Volume: 170
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2023-03-01
Start Page: 317
End Page: 327
Language: English
DOI: 10.1016/j.ygyno.2023.01.035
PUBMED: 36758422
PROVIDER: scopus
DOI/URL:
Notes: Review -- Export Date: 1 March 2023 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Emeline Mariam Aviki
    81 Aviki