TY - JOUR
T1 - Financial toxicity of cancer care in low- and middle-income countries: a systematic review and meta-analysis
AU - DONKOR, Andrew
AU - ATUWO-AMPOH, Vivian Della
AU - YAKANU, Frederick
AU - TORGBENU, Eric
AU - AMEYAW, Edward Kwabena
AU - KITSON-MILLS, Doris
AU - VANDERPUYE, Verna
AU - KYEI, Kofi Adesi
AU - ANIM-SAMPONG, Samuel
AU - KHADER, Omar
AU - KHADER, Jamal
N1 - © 2022. The Author(s).
PY - 2022/9
Y1 - 2022/9
N2 - IntroductionThe 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.AimTo determine the
prevalence, determinants and how financial toxicity has been measured among
cancer patients in LMICs.MethodsFour 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.ResultsA 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.
AB - IntroductionThe 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.AimTo determine the
prevalence, determinants and how financial toxicity has been measured among
cancer patients in LMICs.MethodsFour 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.ResultsA 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.
KW - Cancer
KW - Financial toxicity
KW - Low- and middle-income countries
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85128815404&partnerID=8YFLogxK
U2 - 10.1007/s00520-022-07044-z
DO - 10.1007/s00520-022-07044-z
M3 - Review article
C2 - 35467118
AN - SCOPUS:85128815404
SN - 0941-4355
VL - 30
SP - 7159
EP - 7190
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 9
ER -