Systematic review of financial burden assessment in cancer: Evaluation of measures and utility among adolescents and young adults and caregivers

John M. Salsman, Suzanne C. Danhauer, Justin B. Moore, Edward H. Ip, Laurie E. McLouth, Chandylen L. Nightingale, Christabel K. Cheung, Kristin M. Bingen, Reginald D. Tucker-Seeley, Denisha Little-Greene, Dianna S. Howard, Bryce B. Reeve

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


The cost of cancer care is rising and represents a stressor that has significant and lasting effects on quality of life for many patients and caregivers. Adolescents and young adults (AYAs) with cancer are particularly vulnerable. Financial burden measures exist but have varying evidence for their validity and reliability. The goal of this systematic review is to summarize and evaluate measures of financial burden in cancer and describe their potential utility among AYAs and their caregivers. To this end, the authors searched PubMed, Embase, the Cochrane Library, CINAHL, and PsycINFO for concepts involving financial burden, cancer, and self-reported questionnaires and limited the results to the English language. They discarded meeting abstracts, editorials, letters, and case reports. The authors used standard screening and evaluation procedures for selecting and coding studies, including consensus-based standards for documenting measurement properties and study quality. In all, they screened 7250 abstracts and 720 full-text articles to identify relevant articles on financial burden. Eighty-six articles met the inclusion criteria. Data extraction revealed 64 unique measures for assessing financial burden across material, psychosocial, or behavioral domains. One measure was developed specifically for AYAs, and none were developed for their caregivers. The psychometric evidence and study qualities revealed mixed evidence of methodological rigor. In conclusion, several measures assess the financial burden of cancer. Measures were primarily designed and evaluated in adult patient populations with little focus on AYAs or caregivers despite their increased risk of financial burden. These findings highlight opportunities to adapt and test existing measures of financial burden for AYAs and their caregivers.

Original languageEnglish
Pages (from-to)1739-1748
Number of pages10
Issue number11
StatePublished - Jun 1 2021

Bibliographical note

Publisher Copyright:
© 2021 American Cancer Society


  • cancer
  • caregivers
  • finances
  • measurement
  • systematic review
  • young adult

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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