Assessment of financial toxicity in patients with cancer in Slovenia

Vöröš, Katja (author), Skubic, Marjeta (author), Bavdaž, Mojca (author), Došenović Bonča, Petra (author), Perhavec, Andraž (author), Redek, Tjaša (author), Zobec Logar, Helena Barbara (author), Ratoša, Ivica (author)

Purpose The aim of this study was to assess the extent of financial toxicity in patients with cancer in Slovenia, measured as perceived financial strain and out-of-pocket expenditures. Methods The prospective, cross-sectional study was done at Institute of Oncology Ljubljana from June to October 2023. A newly created individual questionnaire was utilized to obtain data on financial toxicity. Patients completed the questionnaire either on paper or online, with or without the assistance of a researcher. The statistical analysis was based on descriptive and inferential statistics. Results A total of 901 surveys were disseminated, of which 659 were returned, corresponding to a response rate of 73%. Most patients had compulsory health insurance and were diagnosed in the public healthcare system. Following a cancer diagnosis, 178 (27%) patients reported a decline in financial satisfaction (subjective assessment), while 150 (22.7%) patients observed a change in their financial capability (objective assessment). Younger patients (p < 0.001), female patients (p < 0.004), patients with lower net household income (p < 0.001), and patients who were employed before the diagnosis (p < 0.001) were at a greater risk for financial toxicity. Patients with breast cancer and colorectal, endometrial, skin (including melanoma), esophageal, stomach, kidney, bladder cancers, and lymphoma had higher self-reported subjective and objective financial toxicity than patients with prostate, lung, and head and neck cancer. Conclusion This article represents the first comprehensive assessment of financial toxicity among patients with cancer in Slovenia, using perceived financial strain and out-of-pocket expenditures. Most patients reported no significant out-of-pocket costs for the treatment they received. About a quarter of patients with cancer experience financial difficulties.

• Language: English
• Keywords: cancer, finances, financial toxicity, questionnaire, financial burden, out-of-pocket expenditures
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine; EF - School of Economics and Business
• Publication status: Published
• Publication version: Version of Record
• Year: 2025
• Number of pages: 11 str.
• Numbering: Vol. 33, iss. 6, art. 515
• PID: 20.500.12556/RUL-169527
• UDC: 616-006
• ISSN on article: 0941-4355
• DOI: 10.1007/s00520-025-09591-7
• COBISS.SI-ID: 237887491
• Publication date in RUL: 02.06.2025

Record is a part of a journal

• Title: Supportive care in cancer
• Shortened title: Support. care cancer
• Publisher: Springer Nature, Multinational Association of Supportive Care in Cancer
• ISSN: 0941-4355
• COBISS.SI-ID: 1185812

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: onkologija, gmotni položaj, finančna toksičnost