# Screening tools to assess cancer-related financial toxicity: a scoping systematic review and thematic analysis protocol

## TL;DR

This paper reviews global tools for measuring the financial burden of cancer treatment to guide the development of a tool suitable for China.

## Contribution

The study provides a systematic review and thematic analysis protocol to evaluate financial toxicity assessment tools for adaptation in China.

## Key findings

- A comprehensive search of global databases will identify cancer-related financial toxicity assessment tools.
- Key themes and evidence will be extracted to evaluate the applicability of these tools in the Chinese context.
- The GRADE-CERQual system will assess the credibility of evidence for tool applicability.

## Abstract

Financial toxicity, stemming from high cancer treatment costs, compromises adherence, escalates caregiver burden, and induces psychological distress, ultimately hindering patient outcomes and exacerbating health inequities. Despite the development of various assessment tools, a consensus on how to uniformly measure financial toxicity remains elusive. This study aims to systematically analyze the similarities and differences among existing global financial toxicity assessment tools, identify key themes, and grade the evidence, thereby providing a theoretical foundation for developing a financial toxicity assessment tool tailored to the Chinese context.

This review will conduct a comprehensive search of databases, including The Cochrane Library, PubMed, Embase, Web of Science, CNKI, Wanfang, VIP, CBM, grey literature, and health websites from various countries, to identify all tools assessing financial toxicity in cancer patients and their families. The search will cover the period from January 1, 2012, to January 1, 2026. Two reviewers will independently assess the included literature. In cases of disagreement, a third reviewer will adjudicate. Basic characteristics to be described will include the publishing institution, year of publication, country of origin, and applicable drug categories of the assessment tools. Key elements to be extracted and described will focus on dimensions of financial toxicity assessment, sources/evidence grading, and methodological processes, including methods and techniques. Subsequently, the thematic analysis method was adopted to integrate the evidence, extract key themes, and focus on the applicability of existing tools in the Chinese context. The integrated evidence will be evaluated using the GRADE-CERQual evidence quality assessment system to determine the credibility of the evidence for the applicability of existing tools.

This study does not involve human or animal subjects, and ethical approval is not required. The results will be disseminated at various presentations and feedback sessions, in conference abstracts and manuscripts that will be submitted to peer-reviewed journals.

PROSPERO registration number CRD42024546186.