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Background <p>The study investigated the experiences of financial toxicity (FT) amongst cancer patients/survivors in the United Kingdom (UK) and the United States (USA/US).</p> Methods <p>Six hundred cancer patients/survivors residing in the UK (<i>n</i> = 319) or USA/US (<i>n</i> = 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).</p> Results <p>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.</p> Conclusions <p>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.</p>

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Financial toxicity amongst cancer patients and survivors: a comparative study of the United Kingdom and United States

  • 期刊论文

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  • 发表日期：

    2025年5月31日

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  • Tran Thu Ngan,
  • Emily Tonorezos,
  • Michael Donnelly,
  • Ciaran O’Neill

摘要

Background

The study investigated the experiences of financial toxicity (FT) amongst cancer patients/survivors in the United Kingdom (UK) and the United States (USA/US).

Methods

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).

Results

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.

Conclusions

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.