OBJECTIVES: Cancer and cancer care often cause additional costs for patients and their families. Existing instruments addressing the socioeconomic impact of cancer vary in their dimensions. Further, various terminologies have been used in the literature (e.g., financial burden, financial hardship, financial stress) without clear definitions and consistent conceptual background. Based on a systematic review of models addressing the socioeconomic impact of cancer, our goal was to develop a suitable framework for use in European populations.

METHODS: A ‘best-fit’ framework synthesis was applied. First, we systematically identified existing models to generate an a priori framework. Second, we systematically identified relevant European qualitative studies and coded their results against the a priori framework. Thematic analysis and team discussions were applied in these two steps to finalize the (sub-)themes included in the final framework. Third, the model structure and quotes from qualitative studies were revisited to explore relationships between (sub-)themes to form the final conceptual framework. This process was repeated until no further change in (sub-)themes and their relationships emerged.

RESULTS: Eighteen studies containing conceptual models and seven qualitative studies were included. Eight themes and 20 sub-themes were identified in the a priori framework. After the coding process of the included qualitative studies against the a priori framework and team discussions, seven themes and 15 sub-themes were included in the final framework. Based on the identified relationships, we categorised themes into four groups: causes, intermediate consequences, outcomes and risk factors. These groups and their associations formed the conceptual framework for socioeconomic impact research in the European context.

CONCLUSIONS: We propose a ‘socioeconomic impact framework’ based on a systematic review and synthesis of existing models in the field and adapted to the European context. Our proposal will form an integral part of a European consensus proposal by an Organisation European Cancer Institute Taskforce on socioeconomic impact research.