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Supportive Care in Cancer

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Open Access 01-12-2020 | Review Article

Financial toxicity and employment status in cancer survivors. A systematic literature review

Authors: Floortje Mols, Bianca Tomalin, Alison Pearce, Billingsley Kaambwa, Bogda Koczwara

Published in: Supportive Care in Cancer | Issue 12/2020

Abstract

Background

Financial toxicity has traditionally been attributed to the rising costs of cancer care. As ability to work impacts one’s financial situation, limited employment and reduced income may also contribute to financial toxicity. We examined evidence of the association between financial toxicity and employment status in cancer survivors.

Methods

A systematic literature review was performed via PubMed, Web of Science, CINAHL, and PsycINFO with search terms including “Cancer,” “Financial toxicity,” and “Employment” on September 25, 2019.

Results

Thirty-one papers met eligibility criteria. Thirteen studies were rated as having high quality, 16 as adequate, and two as low. Being actively treated for cancer had serious negative consequences on employment and medical expenditures. Unemployment, changed or reduced employment, lost days at work, poor work ability, and changes to employment were associated with a higher risk of financial toxicity. Patients who were younger, non-white, unmarried, of low education, living with dependents, residing in non-metropolitan service areas, with lower income, and of low socioeconomic status were more at risk of financial toxicity. Other variables associated with financial toxicity included having a mortgage/personal loan, higher out of pocket costs and household bills, limited health insurance, more severely ill, on active treatment, and lower functioning or quality of life.

Conclusion

Cancer negatively affects employment, and these changes are significant contributors to financial toxicity. Researchers, healthcare professionals, and patients themselves should all cooperate to tackle these complex issues.

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Title: Financial toxicity and employment status in cancer survivors. A systematic literature review
Authors: Floortje Mols
Bianca Tomalin
Alison Pearce
Billingsley Kaambwa
Bogda Koczwara
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 12/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-020-05719-z

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