ESMO expert consensus statements on the screening and management of financial toxicity in patients with cancer.

assessment tools cancer financial toxicity health insurance coverage sociodemographic factors survivorship

Journal

ESMO open
ISSN: 2059-7029
Titre abrégé: ESMO Open
Pays: England
ID NLM: 101690685

Informations de publication

Date de publication:
15 Apr 2024
Historique:
received: 04 01 2024
revised: 28 02 2024
accepted: 10 03 2024
medline: 17 4 2024
pubmed: 17 4 2024
entrez: 16 4 2024
Statut: aheadofprint

Résumé

Financial toxicity, defined as both the objective financial burden and subjective financial distress from a cancer diagnosis and its treatment, is a topic of interest in the assessment of the quality of life of patients with cancer and their families. Current evidence implicates financial toxicity in psychosocial, economic and other harms, leading to suboptimal cancer outcomes along the entire trajectory of diagnosis, treatment, supportive care, survivorship and palliation. This paper presents the results of a virtual consensus, based on the evidence base to date, on the screening and management of financial toxicity in patients with and beyond cancer organized by the European Society for Medical Oncology (ESMO) in 2022. A Delphi panel of 19 experts from 11 countries was convened taking into account multidisciplinarity, diversity in health system contexts and research relevance. The international panel of experts was divided into four working groups (WGs) to address questions relating to distinct thematic areas: patients with cancer at risk of financial toxicity; management of financial toxicity during the initial phase of treatment at the hospital/ambulatory settings; financial toxicity during the continuing phase and at end of life; and financial risk protection for survivors of cancer, and in cancer recurrence. After comprehensively reviewing the literature, statements were developed by the WGs and then presented to the entire panel for further discussion and amendment, and voting. A total of 25 evidence-informed consensus statements were developed, which answer 13 questions on financial toxicity. They cover evidence summaries, practice recommendations/guiding statements and policy recommendations relevant across health systems. These consensus statements aim to provide a more comprehensive understanding of financial toxicity and guide clinicians globally in mitigating its impact, emphasizing the importance of further research, best practices and guidelines.

Sections du résumé

BACKGROUND BACKGROUND
Financial toxicity, defined as both the objective financial burden and subjective financial distress from a cancer diagnosis and its treatment, is a topic of interest in the assessment of the quality of life of patients with cancer and their families. Current evidence implicates financial toxicity in psychosocial, economic and other harms, leading to suboptimal cancer outcomes along the entire trajectory of diagnosis, treatment, supportive care, survivorship and palliation. This paper presents the results of a virtual consensus, based on the evidence base to date, on the screening and management of financial toxicity in patients with and beyond cancer organized by the European Society for Medical Oncology (ESMO) in 2022.
METHODS METHODS
A Delphi panel of 19 experts from 11 countries was convened taking into account multidisciplinarity, diversity in health system contexts and research relevance. The international panel of experts was divided into four working groups (WGs) to address questions relating to distinct thematic areas: patients with cancer at risk of financial toxicity; management of financial toxicity during the initial phase of treatment at the hospital/ambulatory settings; financial toxicity during the continuing phase and at end of life; and financial risk protection for survivors of cancer, and in cancer recurrence. After comprehensively reviewing the literature, statements were developed by the WGs and then presented to the entire panel for further discussion and amendment, and voting.
RESULTS AND DISCUSSION CONCLUSIONS
A total of 25 evidence-informed consensus statements were developed, which answer 13 questions on financial toxicity. They cover evidence summaries, practice recommendations/guiding statements and policy recommendations relevant across health systems. These consensus statements aim to provide a more comprehensive understanding of financial toxicity and guide clinicians globally in mitigating its impact, emphasizing the importance of further research, best practices and guidelines.

Identifiants

DOI: 10.1016/j.esmoop.2024.102992 PMID: 38626634
pubmed: 38626634
pii: S2059-7029(24)00760-9
doi: 10.1016/j.esmoop.2024.102992
pii:
doi:

Types de publication

Practice Guideline

Langues

eng

Sous-ensembles de citation

IM

Pagination

102992

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

P M Carrera (PM)

German Cancer Research Center, Heidelberg, Germany; Healtempact: Health/Economic Insights-Impact, Hengelo, The Netherlands. Electronic address: pricivel.carrera@gmail.com.

G Curigliano (G)

European Institute of Oncology, IRCCS, Milan; Department of Oncology and Hemato-Oncology, University of Milano, Milan.

D Santini (D)

Oncologia Medica A, Policlinico Umberto 1, La Sapienza Università di Roma, Rome, Italy.

L Sharp (L)

Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.

R J Chan (RJ)

Caring Futures Institute, Flinders University, Adelaide, Australia.

M Pisu (M)

University of Alabama in Birmingham, Birmingham, USA.

F Perrone (F)

National Cancer Institute IRCCS G. Pascale Foundation, Naples, Italy.

S Karjalainen (S)

Tampere University, Tampere, Finland.

G Numico (G)

Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy.

N Cherny (N)

Shaare Zedek Medical Center, Jerusalem, Israel.

E Winkler (E)

National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg University, Medical Faculty, Department of Medical Oncology, Heidelberg, Germany.

M L Amador (ML)

Spanish Association Against Cancer (AECC), Madrid, Spain.

M Fitch (M)

Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.

M Lawler (M)

Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK.

F Meunier (F)

European Initiative on Ending Discrimination against Cancer Survivors and Belgian Royal Academy of Medicine (ARMB), Brussels, Belgium.

N Khera (N)

Mayo Clinic, Phoenix, USA.

G Pentheroudakis (G)

European Society for Medical Oncology, Lugano, Switzerland.

D Trapani (D)

European Institute of Oncology, IRCCS, Milan; Department of Oncology and Hemato-Oncology, University of Milano, Milan.

C I Ripamonti (CI)

University of Brescia, Brescia, Italy.

Classifications MeSH