Financial toxicity of cancer care in low- and middle-income countries: a systematic review and meta-analysis.

Donkor, A; Atuwo-Ampoh, VD; Yakanu, F; Torgbenu, E; Ameyaw, EK; Kitson-Mills, D; Vanderpuye, V; Kyei, KA; Anim-Sampong, S; Khader, O; Khader, J

Financial toxicity of cancer care in low- and middle-income countries: a systematic review and meta-analysis.

Atuwo-Ampoh, VD Yakanu, F Torgbenu, E Ameyaw, EK Kitson-Mills, D Vanderpuye, V Kyei, KA Anim-Sampong, S Khader, O Khader, J

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Publisher:: Springer
Publication Type:: Journal Article
Citation:: Supportive Care in Cancer, 2022, 30, (9), pp. 7159-7190
Issue Date:: 2022-09

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Field	Value	Language
dc.contributor.author	Donkor, A https://orcid.org/0000-0002-6073-524X
dc.contributor.author	Atuwo-Ampoh, VD
dc.contributor.author	Yakanu, F
dc.contributor.author	Torgbenu, E
dc.contributor.author	Ameyaw, EK
dc.contributor.author	Kitson-Mills, D
dc.contributor.author	Vanderpuye, V
dc.contributor.author	Kyei, KA
dc.contributor.author	Anim-Sampong, S
dc.contributor.author	Khader, O
dc.contributor.author	Khader, J
dc.date.accessioned	2022-11-08T03:23:28Z
dc.date.available	2022-04-05
dc.date.available	2022-11-08T03:23:28Z
dc.date.issued	2022-09
dc.identifier.citation	Supportive Care in Cancer, 2022, 30, (9), pp. 7159-7190
dc.identifier.issn	0941-4355
dc.identifier.issn	1433-7339
dc.identifier.uri	http://hdl.handle.net/10453/163306
dc.description.abstract	INTRODUCTION: The costs associated with cancer diagnosis, treatment and care present enormous financial toxicity. However, evidence of financial toxicity associated with cancer in low- and middle-income countries (LMICs) is scarce. AIM: To determine the prevalence, determinants and how financial toxicity has been measured among cancer patients in LMICs. METHODS: Four electronic databases were searched to identify studies of any design that reported financial toxicity among cancer patients in LMICs. Random-effects meta-analysis was used to derive the pooled prevalence of financial toxicity. Sub-group analyses were performed according to costs and determinants of financial toxicity. RESULTS: A total of 31 studies were included in this systematic review and meta-analysis. The pooled prevalence of objective financial toxicity was 56.96% (95% CI, 30.51, 106.32). In sub-group meta-analyses, the objective financial toxicity was higher among cancer patients with household size of more than four (1.17% [95% CI, 1.03, 1.32]; p = 0.02; I2 = 0%), multiple cycles of chemotherapy (1.94% [95% CI, 1.00, 3.75]; p = 0.05; I2 = 43%) and private health facilities (2.87% [95% CI, 1.89, 4.35]; p < 0.00001; I2 = 26%). Included studies hardly focused primarily on subjective measures of financial toxicity, such as material, behavioural and psychosocial. One study reported that 35.4% (n = 152 of 429) of cancer patients experienced high subjective financial toxicity. CONCLUSIONS: This study indicates that cancer diagnosis, treatment and care impose high financial toxicity on cancer patients in LMICs. Further rigorous research on cancer-related financial toxicity is needed.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Springer
dc.relation.ispartof	Supportive Care in Cancer
dc.relation.isbasedon	10.1007/s00520-022-07044-z
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences
dc.subject.classification	Oncology & Carcinogenesis
dc.subject.mesh	Developing Countries
dc.subject.mesh	Financial Stress
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Poverty
dc.subject.mesh	Prevalence
dc.subject.mesh	Developing Countries
dc.subject.mesh	Financial Stress
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Poverty
dc.subject.mesh	Prevalence
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Prevalence
dc.subject.mesh	Developing Countries
dc.subject.mesh	Poverty
dc.subject.mesh	Financial Stress
dc.title	Financial toxicity of cancer care in low- and middle-income countries: a systematic review and meta-analysis.
dc.type	Journal Article
utslib.citation.volume	30
utslib.location.activity	Germany
utslib.for	11 Medical and Health Sciences
utslib.for	17 Psychology and Cognitive Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2022-11-08T03:23:25Z
pubs.issue	9
pubs.publication-status	Published
pubs.volume	30
utslib.citation.issue	9

Abstract:

INTRODUCTION: The costs associated with cancer diagnosis, treatment and care present enormous financial toxicity. However, evidence of financial toxicity associated with cancer in low- and middle-income countries (LMICs) is scarce. AIM: To determine the prevalence, determinants and how financial toxicity has been measured among cancer patients in LMICs. METHODS: Four electronic databases were searched to identify studies of any design that reported financial toxicity among cancer patients in LMICs. Random-effects meta-analysis was used to derive the pooled prevalence of financial toxicity. Sub-group analyses were performed according to costs and determinants of financial toxicity. RESULTS: A total of 31 studies were included in this systematic review and meta-analysis. The pooled prevalence of objective financial toxicity was 56.96% (95% CI, 30.51, 106.32). In sub-group meta-analyses, the objective financial toxicity was higher among cancer patients with household size of more than four (1.17% [95% CI, 1.03, 1.32]; p = 0.02; I2 = 0%), multiple cycles of chemotherapy (1.94% [95% CI, 1.00, 3.75]; p = 0.05; I2 = 43%) and private health facilities (2.87% [95% CI, 1.89, 4.35]; p < 0.00001; I2 = 26%). Included studies hardly focused primarily on subjective measures of financial toxicity, such as material, behavioural and psychosocial. One study reported that 35.4% (n = 152 of 429) of cancer patients experienced high subjective financial toxicity. CONCLUSIONS: This study indicates that cancer diagnosis, treatment and care impose high financial toxicity on cancer patients in LMICs. Further rigorous research on cancer-related financial toxicity is needed.

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http://hdl.handle.net/10453/163306