Greater financial toxicity correlates with increased psychological distress and lower quality of life among Turkish cancer patients
Abstract
Purpose This study aims to investigate the factors that influence financial toxicity and its effects on both quality of life and psychological distress in Turkish cancer patients. Methods Data from 400 cancer patients receiving chemotherapy at a public university in Turkey was analyzed. The Comprehensive Score for Financial Toxicity (COST), Patient Health Questionnaire for Depression and Anxiety (PHQ-4), and Functional Assessment of Cancer Therapy-General (FACT-G) were used to measure financial toxicity, psychological distress, and health quality of life, respectively. Results Patients' median COST score was 22 (SD = 10.1; range: 1-44) and was consistent with mild financial toxicity. Financial toxicity was associated with lower education level (p Conclusion This investigation demonstrated that financial toxicity was a significant determinant of quality of life and psychological distress.
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Previous studies have reported that greater financial toxicity is associated with increased anxiety and psychological distress.
“previous studies that have reported greater financial toxicity being associated with increased anxiety and psychological distress.”
Cites
Löwe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., Schneider, A., & Brähler, E. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.06.019 · Cited by 2,473 · see citing works
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Financial toxicity in older adults with cancer and their caregivers
Kadambi, S., Wang, Y., Job, A., Khankan, L., Yu, T., Patel, A. A., Nipp, R., & Loh, K. (2025) · JCO Oncology Practice · doi:10.1200/op.24.00105 · Cited by 22
Zhang, Z., Xu, Z.-F., Yang, S.-K., Huang, J.-G., Huang, F.-M., & Shi, Y.-M. (2024) · Cancer Management and Research · doi:10.2147/cmar.s470862 · Cited by 17 · see citing works
Defining and Measuring Financial Toxicity in Low- and Middle-Income Countries
Raptis, S., Shkabari, B., Banday, S., & Gyawali, B. (2025) · JCO Oncology Practice · doi:10.1200/op.24.00339 · Cited by 15 · see citing works
Xiao, T., Zhong, H.-Y., Xiao, R., Chen, T., Li, L., & Chen, X.-J. (2023) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2023.10.010 · Cited by 14 · see citing works
Severity of Financial Toxicity for Patients Receiving Palliative Radiation Therapy
Harris, J., Ku, E., Harada, G., Hsu, S., Chiao, E., Rao, P., Healy, E., Nagasaka, M., Humphreys, J., & Hoyt, M. (2023) · The American journal of hospice & palliative care · doi:10.1177/10499091231187999 · Cited by 14
Uyar, G. C., Mirallas, O., Başkurt, K., Martín-Cullell, B., Yeşilbaş, E., Recuero-Borau, J., Kaya, S., Navarro, V., Yücel, S. E., Cano, K. S. V., et al. (2025) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2025.101317 · Cited by 11 · see citing works
Exploring financial toxicity and its impact on health-related quality of life of cancer patients
Ahmad, W., Iqbal, S., & Jamil, Q. (2025) · Supportive Care in Cancer · doi:10.1007/s00520-025-09357-1 · Cited by 9
“Many studies have demonstrated that higher FT, driven by the economic burden of cancer treatment, negatively impacts both physical and emotional well-being, leading to poorer health outcomes [12, 26, 27].”
Ma, G., Long, N., Mao, P., Li, Y., Li, F., & Li, C. (2025) · Asia-Pacific Journal of Oncology Nursing · doi:10.1016/j.apjon.2025.100761 · Cited by 8 · see citing works
“19,20 Relapse and drug resistance may further elevate expenses, and over time, both direct (medications, hospitalization) and indirect costs (lost income, caregiving) accumulate, gradually eroding household finances and patients ’ sense of control.”
InfluentialLiu, L., Liu, M., Liu, Y., Yi, H., Lyu, Z., Xing, S.-J., & Liu, Y. (2025) · Asia-Pacific Journal of Oncology Nursing · doi:10.1016/j.apjon.2025.100699 · Cited by 4 · see citing works
Ahmad, W., Iqbal, S., Shahbaz, A., Ihsan, B., Amir, M., Jamil, M. N., Khan, J. A., & Jamil, Q. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-104642 · Cited by 3
Xu, J., Li, F., Wan, F., Wang, X.-X., Luan, L., Lu, Z.-H., & Liu, Z. (2024) · Scientific Reports · doi:10.1038/s41598-024-67719-x · Cited by 3 · see citing works
Understanding financial toxicity in cancer care through a social–ecological lens
Budhu, J. A., Thom, B., & Chino, F. L. (2026) · Current Opinion in Oncology · doi:10.1097/cco.0000000000001215 · Cited by 1 · see citing works
Mao, Z., Qian, H., Liu, R., & Huo, R. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-04458-x · Cited by 2 · see citing works
“Against the backdrop of high treatment costs for liver cancer and impaired liver function, patients may face agonizing choices between disease treatment and sustaining basic living standards for family members [16].”
Lin, X., Liu, J., Chen, J., Tang, J., Huang, Z., Wang, Y., & Shi, S. (2026) · Asia-Pacific Journal of Oncology Nursing · doi:10.1016/j.apjon.2025.100850 · Cited by 1 · see citing works
“46 Concerns about CAR-T-cell-related toxicity and uncertainty regarding treatment outcomes also contributed to this emotional burden, particularly as CAR-T-cell therapy was often perceived as a last resort after conventional treatments had failed.”
Liu, Y.-F., Wu, L.-F., Nie, K.-Y., Yang, X.-L., & Lyu, Y. (2026) · Patient Preference and Adherence · doi:10.2147/ppa.s616987 · Cited by 1
“27 Previous studies have consistently associated greater financial toxicity with psychological distress, 28 treatment-related difficulties, 29 poorer functioning, 30 and lower quality of life.”
Ertuna, L., Bahçivan, O., Salduz, M., & Kim, Y. (2025) · Supportive Care in Cancer · doi:10.1007/s00520-025-09828-5 · Cited by 1 · see citing works
“However, since the reimbursement of novel treat-ment approaches such as immunotherapy and monoclonal antibodies is limited [29], this might lead to financial unmet needs.”
The experience of subjective financial distress on cancer patients in China: A qualitative study
Yao, T.-Y., Liu, L.-L., Li, X.-X., Chen, M.-X., & Lu, L.-H. (2025) · Supportive Care in Cancer · doi:10.1007/s00520-025-09498-3 · Cited by 1 · see citing works
Financial Toxicity in Plastic Surgery: A Scoping Review.
Plašćević, J., Liang, J., Ludington, S. H., Kim, J., Kaplan, S., Rezak, K., & Patel, A. (2026) · Annals of Plastic Surgery · doi:10.1097/sap.0000000000004914
Altun, H. O., Yağar, F., & Yağar, S. D. (2026) · Supportive Care in Cancer · doi:10.1007/s00520-026-11292-8
“For example, a study conducted in Türkiye reported that female patients had higher levels of financial toxicity [10].”
The self-reinforcing cycle of financial toxicity in Epilepsy: an evolutionary concept analysis.
Boy, Y., Çam, F., Mollaoğlu, M., & Koç, M. (2026) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2026.111291
Jakal, P., Fawaz, M., Hallit, S., Matta, C., & Hemade, A. (2026) · JCO Global Oncology · doi:10.1200/go-25-00688
Development and validation of the subjective financial distress scale for cancer patients
Yao, T.-Y., Liu, L.-L., Li, X.-X., Yu, M.-X., Zhang, S., Zhou, S.-S., Lu, L.-H., & Chen, M.-X. (2026) · BMC Psychology · doi:10.1186/s40359-026-05071-7
“The growing financial burden has adversely affected patients’ physiology and psychology [4].”
Anand, A., Dilip, T. R., Bhandare, M., Chopde, A. N., Patil, S., & Shrikhande, S. (2026) · Journal of Cancer Policy · doi:10.1016/j.jcpo.2026.100730
- Authors
- Yücel, K. B., Özay, Z. I., Sütcüoğlu, O., Yazıcı, O., Üner, A., Günel, N., Özet, A., Savaş, G., & Özdemir, N.
- Affiliations
- Gazi University (TR)
- ORCID
- Venue
- Supportive Care in Cancer
- Published
- 2023-01-26
- Volume
- 31
- Issue
- 2
- Pages
- 137-137
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- OpenAlex
- W4318055097
- Cited by
- 19
- References
- 0
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 4 · 2023: 2
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Supportive Care in Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- financial toxicity, cancer patients, psychological distress, quality of life, chemotherapy, socioeconomic factors, educational attainment, income, sex differences
- MeSH terms
- Financial Stress, Female, Humans, Neoplasms, Quality of Life, Surveys and Questionnaires, Turkey
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