Mapping the Evidence on Interrelationships Between Cancer Stage Financial Toxicity (FT) and Health-Related Quality of Life (HRQoL)
Author(s)
Ali Tafazzoli, PhD1, Sophie Dodman, BSc2, Paulina Bajko, PhD2, Ananth Kashyap, PharmD2, Ike Iheanacho, BSc2, Anuraag Kansal, PhD1.
1GRAIL, Inc., Menlo Park, CA, USA, 2Thermo Fisher Scientific, London, United Kingdom.
1GRAIL, Inc., Menlo Park, CA, USA, 2Thermo Fisher Scientific, London, United Kingdom.
OBJECTIVES: Among the challenges for cancer patients receiving intensive treatments are FT and related reduced HRQoL. While various aspects of the cancer-FT relationship are well-studied, whether or how cancer type and stage influence FT, and its downstream impact on HRQoL, remains unclear. To explore this issue, we conducted a systematic review and evidence-mapping to collate published research.
METHODS: Searches were conducted via Embase, MEDLINE, PsychInfo, and EconLiT to identify relevant studies published within the past 10 years, using pre-defined selection criteria for eligibility. The population, measures of FT and HRQoL, and reported relationships were extracted from each included study. For high-incidence cancers, a targeted review was conducted of studies reporting FT outcomes across both early and late stages, with extraction of statistical methods, effect estimates, and corresponding significance levels.
RESULTS: Of 6,083 citations screened, 150 unique studies were included, representing multiple cancer types, most commonly breast (16% of studies), lung (12%), and gastrointestinal (11%) cancers. COmprehensive Score for FT (COST) (53%) was the most common FT measure, while FACT-G (23%) was the most common HRQoL measure. Both FT and HRQoL were reported in 75% of studies. The targeted review of breast, lung, and gastrointestinal cancers yielded 19 relevant studies with cancer-specific results. Among these, 15 conducted univariate analyses, with 11 showing an association between more advanced disease stage and worse FT and 3 reporting no association; 8 reached statistical significance. Of 8 studies reporting multivariate analyses, 5 showed a directional association, 2 reported no consistent association; 4 reached statistical significance. All 10 studies examining FT and HRQoL found consistent associations.
CONCLUSIONS: There is a broad evidence base relating cancer type and stage, FT, and HRQoL. Evidence of interrelationships between them exists for at least high-incidence cancer types, though further research is needed to confirm the generalizability of those trends.
METHODS: Searches were conducted via Embase, MEDLINE, PsychInfo, and EconLiT to identify relevant studies published within the past 10 years, using pre-defined selection criteria for eligibility. The population, measures of FT and HRQoL, and reported relationships were extracted from each included study. For high-incidence cancers, a targeted review was conducted of studies reporting FT outcomes across both early and late stages, with extraction of statistical methods, effect estimates, and corresponding significance levels.
RESULTS: Of 6,083 citations screened, 150 unique studies were included, representing multiple cancer types, most commonly breast (16% of studies), lung (12%), and gastrointestinal (11%) cancers. COmprehensive Score for FT (COST) (53%) was the most common FT measure, while FACT-G (23%) was the most common HRQoL measure. Both FT and HRQoL were reported in 75% of studies. The targeted review of breast, lung, and gastrointestinal cancers yielded 19 relevant studies with cancer-specific results. Among these, 15 conducted univariate analyses, with 11 showing an association between more advanced disease stage and worse FT and 3 reporting no association; 8 reached statistical significance. Of 8 studies reporting multivariate analyses, 5 showed a directional association, 2 reported no consistent association; 4 reached statistical significance. All 10 studies examining FT and HRQoL found consistent associations.
CONCLUSIONS: There is a broad evidence base relating cancer type and stage, FT, and HRQoL. Evidence of interrelationships between them exists for at least high-incidence cancer types, though further research is needed to confirm the generalizability of those trends.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR151
Topic
Economic Evaluation, Epidemiology & Public Health, Patient-Centered Research
Topic Subcategory
Health State Utilities, Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology