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Cited by 59Economic and Financial Impacts of CancerCancer survivorship and careHealth Systems, Economic Evaluations, Quality of Life

The economic impact of cancer diagnosis to individuals and their families: a systematic review

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Alzehr, Aymen, Hulme, Claire, Spencer, Anne, Morgan-Trimmer, Sarah·2022·Supportive Care in Cancer
DOI 10.1007/s00520-022-06913-xPMC PMC9213304
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Abstract

BACKGROUND: The effect of a cancer diagnosis is wide-ranging with the potential to affect income, employment and risk of poverty. The aim of this systematic review is to identify the economic impact of a cancer diagnosis for patients and their families/caregivers. METHODS: The search covered peer-reviewed journals using MEDLINE, EMBASE, CINAHL, Cochrane Library, Epistemonikos and PsycINFO databases. Quality appraisal was undertaken using CASP tools. Monetary values were converted to US Dollars/2019 using a purchasing power parities (PPP) conversion factor. The review included articles up to and including January 2020, written in English language, for patients with cancer aged ≥ 18 years and focused on the costs up to 5 years following a cancer diagnosis. RESULTS: The search was run in January 2020 and updated in November 2021. Of the 7973 articles identified, 18 met the inclusion criteria. Studies were undertaken in the USA, Ireland, Canada, Australia, France, UK, Malaysia, Pakistan, China and Sri Lanka. The majority were cohort studies. Twelve reported out-of-pocket costs (range US$16-US$2523/month per patient/caregiver) consisting of medical expenses (e.g. surgery, radiotherapy and chemotherapy) and non-medical expenses (e.g. travel, food and childcare). Fourteen studies reported patient/caregiver loss of income and lost productivity (range 14-57.8%). CONCLUSIONS: A high percentage of cancer patients and their families/caregivers experience out-of-pocket expenditure, loss of income and lost productivity. Future research is needed to observe the effects of continuing changes to healthcare policies and social protections on the economic burden among cancer patients and their families/caregivers.

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  • En 14 artículos de una revisión sistemática de 18 estudios con 5748 personas, se mostró pérdida de ingresos y productividad del cuidador y del paciente, asociada a dificultades económicas.

    “Ochoa et al.Recoge 18 estudios con una muestra total de 5748 personas.En este estudio 14 artículos mostraron una perdida tanto de ingresos y de productividad del cuidador y del paciente, asociado a dificultades económicas.”

    From Sobrecarga de trabajo en cuidadores de pacientes en cuidados paliativos oncológicos: Una revisión bibliográfica (2023) · cites this paper as Alzehr et al., 2022

    The Results (Description of the studies; Loss of income/lost productivity) report 18 included studies, 14 of which addressed loss of income or productivity. The Cancer caregiving results and Conclusion describe economic effects on caregivers and patients. Our copy does not establish the claimed total sample of 5,748 people; the 14 studies also used varied measures rather than each demonstrating both income and productivity loss in both groups. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Un alto porcentaje de pacientes, cuidadores y familias experimentan pérdida de ingresos, incremento de gastos y pérdida de productividad.

    “un alto porcentaje tanto de pacientes como de cuidadores y familias que experimentan situaciones de pérdida de ingresos, un incremento en los gastos, así como una pérdida de productividad (Alzehr et al., 2022).”

    From Sobrecarga de trabajo en cuidadores de pacientes en cuidados paliativos oncológicos: Una revisión bibliográfica (2023) · cites this paper as Alzehr et al., 2022

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Research works printed but not linked: 51

  1. [1]Jemal A Ward EM Johnson CJ Cronin KA Ma J Ryerson AB Mariotto A Lake AJ Wilson R Sherman RL Anderson RN Annual report to the nation on the status of cancer, 1975–2014, featuring survival JNCI: J Natl Cancer Inst 2017 109 9 djx030 10.1093/jnci/djx030 PMC5409140 28376154 · DOI
  2. [2]De Moor JS Mariotto AB Parry C Alfano CM Padgett L Kent EE Forsythe L Scoppa S Hachey M Rowland JH Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care Cancer Epidemiol Prev Biomark 2013 22 4 561 570 10.1158/1055-9965.EPI-12-1356 PMC3654837 23535024 · DOI · Paper page
  3. [3]Burstein HJ Krilov L Aragon-Ching JB Baxter NN Chiorean EG Chow WA De Groot JF Devine SM DuBois SG El-Deiry WS Epstein AS Clinical cancer advances 2017: annual report on progress against cancer from the American Society of Clinical Oncology J Clin Oncol 2017 35 12 1341 1367 10.1200/JCO.2016.71.5292 28148207 · DOI
  4. [4]Gordon LG Merollini KM Lowe A Chan RJ A systematic review of financial toxicity among cancer survivors: we can’t pay the co-pay The Patient-Patient-Centered Outcomes Res 2017 10 3 295 309 10.1007/s40271-016-0204-x 27798816 · DOI
  5. [5]Schoen C Doty MM Robertson RH Collins SR Affordable Care Act reforms could reduce the number of underinsured US adults by 70 percent Health Aff 2011 30 9 1762 1771 10.1377/hlthaff.2011.0335 21900668 · DOI
  6. [6]Kankeu HT Saksena P Xu K Evans DB The financial burden from non-communicable diseases in low-and middle-income countries: a literature review Health Res Policy Syst 2013 11 1 1 2 10.1186/1478-4505-11-31 23947294 PMC3751656 · DOI
  7. [7]Fitch MI Longo CJ Chan RJ Cancer patients’ perspectives on financial burden in a universal healthcare system: analysis of qualitative data from participants from 20 provincial cancer centers in Canada Patient Educ Couns 2021 104 4 903 910 10.1016/j.pec.2020.08.013 32843264 · DOI
  8. [8]Currow D Aranda S Financial toxicity in clinical care today: a “menu without prices” Med J Aust 2016 204 11 397 10.5694/mja16.00182 27318391 · DOI
  9. [9]Iragorri N de Oliveira C Fitzgerald N Essue B The out-of-pocket cost burden of cancer care—a systematic literature review Curr Oncol 2021 28 2 1216 1248 10.3390/curroncol28020117 33804288 PMC8025828 · DOI
  10. [10]Altice CK Banegas MP Tucker-Seeley RD Yabroff KR Financial hardships experienced by cancer survivors: a systematic review JNCI: J Natl Cancer Inst 2017 109 2 djw205 10.1093/jnci/djw205 27754926 PMC6075571 · DOI · Paper page
  11. [11]Pearce A Tomalin B Kaambwa B Horevoorts N Duijts S Mols F van de Poll-Franse L Koczwara B Financial toxicity is more than costs of care: the relationship between employment and financial toxicity in long-term cancer survivors J Cancer Surviv 2019 13 1 10 20 10.1007/s11764-018-0723-7 30357537 · DOI
  12. [12]Mehnert A Employment and work-related issues in cancer survivors Crit Rev Oncol Hematol 2011 77 2 109 130 10.1016/j.critrevonc.2010.01.004 20117019 · DOI
  13. [13]Girgis A Lambert S Johnson C Waller A Currow D Physical, psychosocial, relationship, and economic burden of caring for people with cancer: a review J Oncol Pract 2013 9 4 197 202 10.1200/JOP.2012.000690 23942921 PMC3710169 · DOI · Paper page
  14. [14]Mols F Tomalin B Pearce A Kaambwa B Koczwara B Financial toxicity and employment status in cancer survivors. A systematic literature review Support Care Cancer 2020 28 1 16 10.1007/s00520-020-05719-z PMC7686183 32865673 · DOI
  15. [15]Mujahid MS Janz NK Hawley ST Griggs JJ Hamilton AS Graff J Katz SJ Racial/ethnic differences in job loss for women with breast cancer J Cancer Surviv 2011 5 1 102 111 10.1007/s11764-010-0152-8 20936435 PMC3040347 · DOI
  16. [16]Longo CJ, Fitch MI, Banfield L, Hanly P, Yabroff KR, Sharp L (2020) Financial toxicity associated with a cancer diagnosis in publicly funded healthcare countries: a systematic review. Supportive Care in Cancer 1-21. 10.1007/s00520-020-05620-9 32653957 · DOI
  17. [17]Guy GP Jr Ekwueme DU Yabroff KR Dowling EC Li C Rodriguez JL de Moor JS Virgo KS Economic burden of cancer survivorship among adults in the United States J Clin Oncol 2013 31 30 3749 10.1200/2FJCO.2013.49.1241 24043731 PMC3795887 · DOI
  18. [18]Liberati A Altman DG Tetzlaff J Mulrow C Gøtzsche PC Ioannidis JP Clarke M Devereaux PJ Kleijnen J Moher D The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration J Clin Epidemiol 2009 62 10 e1 34 10.1016/j.jclinepi.2009.06.006 19631507 · DOI · Paper page
  19. [19]Critical Appraisal Skills Programme (2021) CASP Systematic Review Checklist https://casp-uk.net/casp-tools-checklists/. Accessed 1 September 2020.
  20. [21]Amarasinghe H Jayasinghe RD Dharmagunawardene D Attygalla M Scuffham PA Johnson N Kularatna S Economic burden of managing oral cancer patients in Sri Lanka: a cross-sectional hospital-based costing study BMJ Open 2019 9 7 e027661 10.1136/bmjopen-2018-027661 31326930 PMC6661677 · DOI
  21. [22]Carey M Paul C Cameron E Lynagh M Hall A Tzelepis F Financial and social impact of supporting a haematological cancer survivor Eur J Cancer Care 2012 21 2 169 176 10.1111/j.1365-2354.2011.01302.x PMC3508421 22070745 · DOI
  22. [23]Céilleachair AÓ Costello L Finn C Timmons A Fitzpatrick P Kapur K Staines A Sharp L Inter-relationships between the economic and emotional consequences of colorectal cancer for patients and their families: a qualitative study BMC Gastroenterol 2012 12 1 1 10.1186/1471-230X-12-62 22676509 PMC3406941 · DOI
  23. [24]Céilleachair AÓ Hanly P Skally M O’Leary E O’Neill C Fitzpatrick P Kapur K Staines A Sharp L Counting the cost of cancer: out-of-pocket payments made by colorectal cancer survivors Support Care Cancer 2017 25 9 2733 2741 10.1007/s00520-017-3683-y 28341973 · DOI
  24. [25]Gordon L Scuffham P Hayes S Newman B Exploring the economic impact of breast cancers during the 18 months following diagnosis Psycho Oncol: J Psychol Soc Behav Dimens Cancer 2007 16 12 1130 9 10.1002/pon.1182 17345557 · DOI
  25. [26]Hanly P Céilleachair AÓ Skally M O’Leary E Kapur K Fitzpatrick P Staines A Sharp L How much does it cost to care for survivors of colorectal cancer? Caregiver’s time, travel and out-of-pocket costs Support Care Cancer 2013 21 9 2583 2592 10.1007/s00520-013-1834-3 23649879 PMC6763575 · DOI
  26. [27]Jagsi R Pottow JA Griffith KA Bradley C Hamilton AS Graff J Katz SJ Hawley ST Long-term financial burden of breast cancer: experiences of a diverse cohort of survivors identified through population-based registries J Clin Oncol 2014 32 12 1269 10.1200/JCO.2013.53.0956 24663041 PMC3986387 · DOI
  27. [28]Lauzier S Maunsell E Drolet M Coyle D Hébert-Croteau N Brisson J Mâsse B Abdous B Robidoux A Robert J Wage losses in the year after breast cancer: extent and determinants among Canadian women J Natl Cancer Inst 2008 100 5 321 332 10.1093/jnci/djn028 18314472 · DOI
  28. [29]Lauzier S Maunsell E Drolet M Coyle D Hébert-Croteau N Brisson J Mâsse B Abdous B Robidoux A Robert J Wage losses in the year after breast cancer: extent and determinants among Canadian women J Natl Cancer Inst 2008 100 5 321 332 10.1093/jnci/djn028 18314472 · DOI
  29. [30]Li C Zeliadt SB Hall IJ Smith JL Ekwueme DU Moinpour CM Penson DF Thompson IM Keane TE Ramsey SD Burden among partner caregivers of patients diagnosed with localized prostate cancer within 1 year after diagnosis: an economic perspective Support Care Cancer 2013 21 12 3461 3469 10.1007/s00520-013-1931-3 23955026 PMC4535430 · DOI
  30. [31]Mahmood HZ Khaliq IH Bhatti ZI Wilson KJ Gondal KM Malik S Zaman S Household costs of breast cancer morbidity: an empirical assessment from Pakistan JBUON 2018 23 Suppl 1 S28 33 10.2139/ssrn.3377176 30722109 · DOI
  31. [32]Marti J Hall PS Hamilton P Hulme CT Jones H Velikova G Ashley L Wright P The economic burden of cancer in the UK: a study of survivors treated with curative intent Psychooncol 2016 25 1 77 83 10.1002/pon.3877 26087260 · DOI
  32. [33]Pisu M Azuero A Meneses K Burkhardt J McNees P Out of pocket cost comparison between Caucasian and minority breast cancer survivors in the Breast Cancer Education Intervention (BCEI) Breast Cancer Res Treat 2011 127 2 521 529 10.1007/s10549-010-1225-0 20976542 PMC3087852 · DOI
  33. [34]Tison A Sagaon-Teyssier L Sansonetti C Blatier JF Paraponaris A Transitions in the labor market after cancer: a comparison of self-employed workers and salaried staff Support Care Cancer 2016 24 12 4879 4886 10.1007/s00520-016-3343-7 27577189 · DOI
  34. [35]Su TT Azzani M Tan FL Loh SY Breast cancer survivors: return to work and wage loss in selected hospitals in Malaysia Support Care Cancer 2018 26 5 1617 1624 10.1007/s00520-017-3987-y 29209834 · DOI
  35. [36]Vayr F Montastruc M Savall F Despas F Judic E Basso M Dunet C Dalenc F Laurent G Soulat JM Herin F Work adjustments and employment among breast cancer survivors: a French prospective study Support Care Cancer 2020 28 1 185 192 10.1007/s00520-019-04799-w 31001691 · DOI
  36. [37]Zhang X Liu S Liu Y Du J Fu W Zhao X Huang W Zhao X Liu G Mao Z Hu TW Economic burden for lung cancer survivors in urban China Int J Environ Res Public Health 2017 14 3 308 10.3390/ijerph14030308 PMC5369144 28294998 · DOI
  37. [38]Humphries B Lauzier S Drolet M Coyle D Mâsse B Provencher L Robidoux A Maunsell E Wage losses among spouses of women with nonmetastatic breast cancer Cancer 2020 126 5 1124 1134 10.1002/cncr.32638 31821547 · DOI
  38. [39]Fitch MI, Sharp L, Hanly P, Longo CJ (2021) Experiencing financial toxicity associated with cancer in publicly funded healthcare systems: a systematic review of qualitative studies. Journal of Cancer Survivorship 1-15. 10.1007/s11764-021-01025-7 33723742 · DOI
  39. [40]Laba TL Essue BM Jan S Financing options to sustain Medicare: are we committed to universalism Med J Aust 2015 203 6 244 245 10.5694/mja15.00431 26377286 · DOI
  40. [41]de Souza JA Wong YN Financial distress in cancer patients J medicine person 2013 11 2 73 77 10.1007/s12682-013-0152-3 PMC3859450 24349677 · DOI
  41. [42]Gordon LG Walker SM Mervin MC Lowe A Smith DP Gardiner RA Chambers SK Financial toxicity: a potential side effect of prostate cancer treatment among Australian men Eur J Cancer Care 2017 26 1 e12392 10.1111/ecc.12392 PMC5297983 26423576 · DOI
  42. [43]ACTION Study Group Financial catastrophe, treatment discontinuation and death associated with surgically operable cancer in South-East Asia: results from the ACTION Study Surgery 2015 157 6 971 982 10.1016/j.surg.2015.02.012 25934082 · DOI
  43. [47]Mittmann N Liu N Porter J Seung SJ Isogai PK Saskin R Cheung MC Leighl NB Hoch JS Trudeau M Evans WK Utilization and costs of home care for patients with colorectal cancer: a population-based study Can Medical Assoc Open Access J 2014 2 1 E11 E17 10.9778/cmajo.20130026 PMC3986021 25077120 · DOI
  44. [48]Arozullah AM Calhoun EA Wolf M Finley DK Fitzner KA Heckinger EA Gorby NS Schumock GT Bennett CL The financial burden of cancer: estimates from a study of insured women with breast cancer J Support Oncol 2004 2 3 271 278 15328826
  45. [49]Lorgelly PK Neri M Survivorship burden for individuals, households and society: estimates and methodology J Cancer Policy 2018 15 113 117 10.1016/j.jcpo.2018.02.005 · DOI
  46. [50]Sharp L Timmons A Pre-diagnosis employment status and financial circumstances predict cancer-related financial stress and strain among breast and prostate cancer survivors Support Care Cancer 2016 24 2 699 709 10.1007/s00520-015-2832-4 26143038 · DOI
  47. [51]Brooks J Wilson K Amir Z Additional financial costs borne by cancer patients: a narrative review Eur J Oncol Nurs 2011 15 4 302 310 10.1016/j.ejon.2010.10.005 21093369 · DOI
  48. [52]Blinder VS Murphy MM Vahdat LT Gold HT de Melo-Martin I Hayes MK Scheff RJ Chuang E Moore A Mazumdar M Employment after a breast cancer diagnosis: a qualitative study of ethnically diverse urban women J Community Health 2012 37 4 763 772 10.1007/s10900-011-9509-9 22109386 · DOI
  49. [53]Roelen CA Koopmans PC van Rhenen W Groothoff JW van der Klink JJ Bültmann U Trends in return to work of breast cancer survivors Breast Cancer Res Treat 2011 128 1 237 242 10.1007/s10549-010-1330-0 21197566 · DOI
  50. [54]Islam T Dahlui M Abd Majid H Nahar AM Taib NA Su TT Factors associated with return to work of breast cancer survivors: a systematic review BMC Public Health 2014 14 3 1 3 10.1186/1471-2458-14-S3-S8 25437351 PMC4251139 · DOI
  51. [55]Van Houtven CH Ramsey SD Hornbrook MC Atienza AA van Ryn M Economic burden for informal caregivers of lung and colorectal cancer patients Oncologist 2010 15 8 883 10.1634/theoncologist.2010-0005 20667966 PMC3228017 · DOI

Cited by

Sorted by citations

Authors
Alzehr, A., Hulme, C., Spencer, A., & Morgan-Trimmer, S.
Affiliations
University of Exeter (GB)
Corresponding author
Alzehr, Aymen
ORCID
Venue
Supportive Care in Cancer
Publisher
Springer Science and Business Media LLC
Published
2022-03-02
Volume
30
Issue
8
Pages
6385-6404
ISSN
  • 0941-4355 (ISSN-L)
  • 1433-7339
DOI
10.1007/s00520-022-06913-x
PMC
PMC9213304
OpenAlex
W4214927185
Cited by
59
References
1
Citations by year
2026: 7 · 2025: 16 · 2024: 21 · 2023: 14 · 2022: 1
FWCI
2.40
Type
journal article
Language
en
Open access
Licence
Locations
  • Supportive Care in Cancer (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Figshare (acceptedVersion, cc-by)
  • Open Research Exeter (University of Exeter) (submittedVersion, cc-by)
Funders
Saudi Arabia Cultural Bureau in London
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
cancer diagnosis, economic burden of cancer, out-of-pocket costs, income loss, productivity loss, caregivers, family caregivers, poverty risk, health care costs
MeSH terms
Employment, Health Expenditures, Humans, Income, Neoplasms, Caregivers

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