Financial Toxicity Among Cancer Patients in Slovenia

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-04-21 DOI:10.1002/cam4.70891

Marjeta Skubic, Katja Vöröš, Mojca Bavdaž, Petra Došenović Bonča, Andraž Perhavec, Tjaša Redek, Ivica Ratoša, Helena Barbara Zobec Logar

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Abstract

Background

The ageing population, increasing medical costs and a number of newly diagnosed cancer cases among the working population are increasing the financial burden on healthcare systems. The extent of financial toxicity in Slovenian patients has been insufficiently researched, as has its impact on quality of life (QoL).

Methods

To evaluate financial toxicity, the Functional Assessment of Chronic Illness Therapy (COST-FACIT) questionnaire was translated into Slovenian, validated, introduced and compared with the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Additional questions were incorporated into the questionnaire to further quantify and objectify financial toxicity.

The study was cross-sectional. The statistical analysis was based on descriptive and inferential statistics and exploratory data analysis.

Results

Out of 590 analysed participants, financial toxicity was absent in 57.2% but present at mild to moderate levels in 42.8%. Key risk factors included lower income, age ≤ 65, employment, active oncologic treatment, rural residence and religious affiliation. Post hoc analyses showed higher financial toxicity in those with ≤ 600 EUR monthly income, employed patients and spiritual individuals, while cancer type showed no significant differences. The correlation between financial toxicity and QoL was mild. Objective measures of financial toxicity include direct costs (e.g., transportation, supplements and medical devices) and indirect costs (e.g., loss of income) associated with disease and treatment, which burdened more than 40% of the studied population.

Conclusions

The COST-FACIT proved to be a helpful screening tool for identifying patients at risk, even in a public healthcare system such as the Slovenian system. On average, financial toxicity is low due to the publicly funded financial system covering the treatment and rehabilitation of malignant diseases. The age structure of cancer patients and secure pension income further contribute to this outcome.

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斯洛文尼亚癌症患者的财务毒性

人口老龄化、医疗费用增加以及工作人口中新诊断的癌症病例增加，增加了医疗保健系统的财政负担。斯洛文尼亚患者的财务毒性程度及其对生活质量（QoL）的影响尚未得到充分研究。方法将慢性疾病治疗功能评估（COST-FACIT）问卷翻译成斯洛文尼亚文，进行验证、引入，并与欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ-C30）进行比较，以评估财务毒性。问卷中加入了其他问题，以进一步量化和客观化财务毒性。这项研究是横断面的。统计分析采用描述性、推断性统计和探索性数据分析。结果在590名分析的参与者中，57.2%的人没有财务毒性，但42.8%的人存在轻度至中度水平。主要危险因素包括低收入、年龄≤65岁、就业、积极的肿瘤治疗、农村居住和宗教信仰。事后分析显示，月收入≤600欧元的患者、受雇患者和精神个体的财务毒性更高，而癌症类型没有显着差异。财务毒性与生活质量的相关性较弱。财务毒性的客观衡量标准包括与疾病和治疗相关的直接成本（例如运输、补品和医疗设备）和间接成本（例如收入损失），这给40%以上的研究人口造成了负担。结论：事实证明，即使在斯洛文尼亚这样的公共卫生系统中，成本-事实证明是一种有用的筛查工具，可以识别有风险的患者。平均而言，财政毒性较低，因为公共资助的财政体系涵盖了恶性疾病的治疗和康复。癌症患者的年龄结构和稳定的养老金收入也有助于这一结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.