Ngan Tran Thu, Tonorezos Emily, Donnelly Michael, O'Neill Ciaran
Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
Support Care Cancer. 2025 May 31;33(6):521. doi: 10.1007/s00520-025-09568-6.
The study investigated the experiences of financial toxicity (FT) amongst cancer patients/survivors in the United Kingdom (UK) and the United States (USA/US).
Six hundred cancer patients/survivors residing in the UK (n = 319) or USA/US (n = 281) completed an online cross-sectional survey using the COmprehensive Score for financial Toxicity (COST)-a validated measure of FT. Severity of FT was defined as 'no' (COST scores ≥ 26), 'mild' (14-25), and 'moderate/severe' (0-13).
Thirty-four percent of UK participants faced FT which was significantly lower compared to the USA/US at 55% (crude OR = 2.44, 95% CI 1.73-3.42). An ordered logistic regression model showed that in the USA/US, being 65 + years old (adjusted OR = 0.19, 95% CI 0.07-0.48), retired (aOR = 0.26, 95% CI 0.09-0.75), and having a higher household income (aOR ranged 0.03-0.19) decreased the risk of FT, whilst being female increased the risk (aOR = 1.83, 95% CI 1.01-3.32). In the UK, age and sex did not have an effect, but higher income and being retired showed an identical pattern compared to the US.
FT was less prevalent and less severe in the UK, compared to the USA/US. The high prevalence of FT underscores the need to provide an additional level of protection to the most vulnerable groups than is currently offered in either country.
该研究调查了英国（UK）和美国（USA/US）癌症患者/幸存者的经济毒性（FT）经历。
600名居住在英国（n = 319）或美国（n = 281）的癌症患者/幸存者完成了一项在线横断面调查，使用经济毒性综合评分（COST）——一种经过验证的FT测量方法。FT的严重程度定义为“无”（COST评分≥26）、“轻度”（14 - 25）和“中度/重度”（0 - 13）。
34%的英国参与者面临FT，这一比例显著低于美国的55%（粗比值比[OR] = 2.44，95%置信区间[CI] 1.73 - 3.42）。有序逻辑回归模型显示，在美国/美国，65岁及以上（调整后OR = 0.19，95% CI 0.07 - 0.48）、退休（调整后OR = 0.26，95% CI 0.09 - 0.75）以及家庭收入较高（调整后OR范围为0.03 - 0.19）会降低FT风险，而女性会增加风险（调整后OR = 1.83，95% CI 1.01 - 3.32）。在英国，年龄和性别没有影响，但与美国相比较高收入和退休呈现相同模式。
与美国相比，FT在英国的患病率较低且严重程度较轻。FT的高患病率凸显了需要为最脆弱群体提供比两国目前所提供的更高水平保护的必要性。
