Longitudinal studies on financial toxicity in cancer patients: a scoping review

TL;DR

This review explores how cancer patients experience financial stress over time, highlighting differences across cancer types and the need for better tools to track long-term impacts.

Contribution

The study identifies specific trends and gaps in measuring financial toxicity across different cancers and proposes directions for future research.

Findings

Financial toxicity trends vary by cancer type, with breast cancer showing stability and colorectal cancer showing an upward trend.

Most studies focus on the first year after treatment, with limited long-term follow-up.

25 influencing factors were identified, spanning sociodemographic, disease-related, economic, and psychosocial dimensions.

Abstract

This scoping review focuses on financial toxicity in cancer patients, aiming to identify its measurement time points, assessment tools, developmental trends, and influencing factors. Based on existing evidence, this review reveals the occurrence trajectory and long-term impacts of financial toxicity among cancer patients. It can provide a reference for improving patients’ financial well-being in clinical practice and optimizing the medical security system at the health policy level and also points out key directions for future related research.

This study strictly followed the methodology of scoping review. A systematic search was performed across the databases including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Data, VIP, and Chinese Biomedical Literature Database (CBM). The search period covered from the inception of each database to November 8, 2025.

A total of 14 articles were included in this study. The common measurement time points were selected as before the initiation of treatment, 3 months, 6 months, and 12 months after the start of treatment. The research tools combined subjective scales with objective data measurement, and the Comprehensive Score for Financial Toxicity-Patient-Reported Outcome Measure (COST-PROM) was adopted in most studies. The changing trend of financial toxicity among breast cancer patients tended to be stable. The financial toxicity of colorectal cancer patients showed a continuous upward trend, while that of esophageal cancer patients presented a continuous downward trend. The financial toxicity of cervical cancer patients also demonstrated a declining trend, though the magnitude of change was smaller than that of esophageal cancer patients. A total of 25 influencing factors of financial toxicity in cancer patients were identified, involving four dimensions: sociodemographic factors (4), disease-related factors (4), economic-related factors (11), and psychosocial factors (6).

The measurement time points of financial toxicity in cancer patients are mostly concentrated within one year after treatment, with insufficient research on long-term follow-up. The existing assessment tools lack applicability for long-term tracking and specificity for different cancer types, and objective indicators fail to effectively reflect patients’ economic status due to disparities in regional economic development levels. Patients with different types of cancer exhibit distinct developmental trends of financial toxicity, indicating population heterogeneity. Future research still needs to further explore the influencing factors and developmental trajectories of financial toxicity among different cancer types.

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