Sunnybrook Research Institute, Toronto, ON, Canada.
Health Intervention and Technology Assessment Program, Bangkok, Thailand.
Support Care Cancer. 2022 Aug;30(8):6463-6471. doi: 10.1007/s00520-022-06952-4. Epub 2022 Mar 23.
In the past decade, literature has called attention to financial toxicities experienced by cancer patients. Though studies have addressed research questions in high-income countries, there remains a paucity of in-depth reviews regarding low- and middle-income countries (LMICs). Our scoping review provides an overview of treatment-related financial toxicities experienced by cancer patients in LMICs.
A systematic search was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. English peer-reviewed articles that (a) explored patients' experience with financial toxicity due to cancer treatment (b) were specific to LMICs as defined by the World Bank and (c) focused on qualitative data were included. Details regarding participants and main findings were extracted and synthesized.
The search yielded 6290 citations, and 42 studies across 3 low-income, 9 lower-middle-income and 8 upper-middle-income countries. Main themes identified included cancer patients encountered various material hardships, managed costs with different coping behaviours and experienced negative psychological responses to their financial burden. Higher levels of financial toxicities were associated with patient characteristics such as lower socio-economic status and lack of insurance, as well as patient outcomes such as lower quality of life.
Cancer patients in LMIC experience deleterious financial toxicities as a result of treatment. This comprehensive characterization of financial toxicities will better allow health systems to adopt evidence-based mitigation strategies to reduce the financial burden on patients.
在过去的十年中，文献已经引起了人们对癌症患者所经历的财务毒性的关注。尽管研究已经解决了高收入国家的研究问题，但关于低收入和中等收入国家（LMICs）的深入审查仍然很少。我们的范围综述提供了对 LMICs 中癌症患者经历的与治疗相关的财务毒性的概述。
在 MEDLINE、EMBASE 和 Cochrane 对照试验中心注册库中进行了系统搜索。包括以下条件的英文同行评审文章：（a）探讨了由于癌症治疗而导致的患者财务毒性的经历；（b）具体针对世界银行定义的 LMICs；（c）专注于定性数据。提取并综合了参与者和主要发现的详细信息。
搜索结果产生了 6290 条引用，涉及 3 个低收入国家、9 个中下收入国家和 8 个中上收入国家的 42 项研究。确定的主要主题包括癌症患者遇到了各种物质困难，通过不同的应对行为管理成本，以及对财务负担产生负面的心理反应。更高水平的财务毒性与患者特征（如较低的社会经济地位和缺乏保险）以及患者结果（如较低的生活质量）有关。
LMIC 中的癌症患者因治疗而经历有害的财务毒性。对财务毒性的这种全面描述将使卫生系统更好地采用基于证据的缓解策略，以减轻患者的经济负担。
