Vancoppenolle J, Franzen N, Azarang L, Juslin T, Krini M, Lubbers T, Mattson J, Mayeur D, Menezes R, Schmitt J, Scotte F, Seoane López O, Skaali T, Ubels J, Schlander M, Retel V, van Harten W H
Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam, Amsterdam; Health Technology and Services Research Department, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam, Amsterdam.
ESMO Open. 2025 Jun;10(6):105293. doi: 10.1016/j.esmoop.2025.105293. Epub 2025 Jun 9.
Even with universal health care, patients living with cancer often face substantial treatment-related costs and income loss in Europe. Insights into the socioeconomic impact of cancer within and across countries are needed to create awareness, inform policy, and develop targeted measurement instruments. The SEC study aims to explore the socioeconomic impact and financial toxicity of cancer and identify vulnerable patient groups across Europe.
To investigate experiences of a large number of patients, data were collected in a collaborative effort of hospitals and patient organizations across Europe through convenience sampling. Patients undergoing treatment currently or treated within the past 2 years could participate. A 44-item survey was developed to measure the socioeconomic impact following a cancer diagnosis. The primary outcome was the level of financial toxicity, measured by the Financial Index of Toxicity (FIT) score. To identify vulnerable groups, multiple regression analyses were used to investigate the association between the FIT score, clinical characteristics, and socioeconomic demographics, including cancer type, employment status, and country of residence.
A total of 2507 patients across Europe met the inclusion criteria. Fifty-six percent of the patients reported income loss and 86% additional treatment-related expenses. Sixteen percent of patients delayed or avoided medical visits, buying medication, surgery, or other health services. Next to a significant association of the country of residence, our regression models demonstrated that divorced, self-employed patients who were younger (-0.02; P = 0.000) and lower educated (0.75; P = 0.000) with a lower household income (1.21; P = 0.000) and children (0.21; P = 0.000) at the time of diagnosis reported significantly higher FIT scores compared with older patients who were married (-0.56; P = 0.000), retired (-1.55; P = 0.000), or employed (-0.56; P = 0.000).
In every European Union country, a substantial number of patients with cancer report serious financial consequences and stress. Further research is critical to inform well-tailored policies and interventions to limit the socioeconomic impact on patients with cancer.
即使在全民医疗保健的情况下，欧洲的癌症患者仍常常面临与治疗相关的巨额费用和收入损失。需要深入了解癌症在各国国内及跨国的社会经济影响，以提高认识、为政策提供依据并开发针对性的测量工具。SEC研究旨在探讨癌症的社会经济影响和经济毒性，并确定欧洲各地的脆弱患者群体。
为调查大量患者的经历，欧洲各地的医院和患者组织通过便利抽样共同收集数据。目前正在接受治疗或在过去两年内接受过治疗的患者均可参与。开发了一项包含44个项目的调查问卷，以衡量癌症诊断后的社会经济影响。主要结局是经济毒性水平，通过毒性财务指数（FIT）评分来衡量。为确定脆弱群体，采用多元回归分析来研究FIT评分、临床特征和社会经济人口统计学之间的关联，包括癌症类型、就业状况和居住国。
欧洲共有2507名患者符合纳入标准。56%的患者报告有收入损失，86%的患者有额外的治疗相关费用。16%的患者推迟或避免就医、购买药物、手术或其他医疗服务。除了居住国存在显著关联外，我们的回归模型表明，诊断时离婚、自营职业、年龄较小（-0.02；P = 0.000）、受教育程度较低（0.75；P = 0.000）、家庭收入较低（1.21；P = 0.000）且有子女（0.21；P = 0.000）的患者，其FIT评分显著高于诊断时已婚（-0.56；P = 0.000）、退休（-1.55；P = 0.000）或就业（-0.56；P = 0.000）的老年患者。
在每个欧盟国家，大量癌症患者报告了严重的经济后果和压力。进一步的研究对于制定精心定制的政策和干预措施以限制癌症对患者的社会经济影响至关重要。
