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. 2025 May 30;33(6):515.
doi: 10.1007/s00520-025-09591-7.

Assessment of financial toxicity in patients with cancer in Slovenia

Katja Vöröš  1 , Marjeta Skubic  1 , Mojca Bavdaž  2 , Petra Došenović Bonča  2 , Andraž Perhavec  1   3 , Tjaša Redek  2 , Helena Barbara Zobec Logar  1   4 , Ivica Ratoša  5   6
Affiliations

Assessment of financial toxicity in patients with cancer in Slovenia

Katja Vöröš et al. Support Care Cancer. .

Abstract

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.

Keywords: Cancer; Finances; Financial burden; Financial toxicity; Out-of-pocket expenditures; Questionnaire.

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Conflict of interest statement

Declarations. Ethics approval: The study was approved by the Institutional Review Board and Ethical Committee (approval number ERIDNPVO-0031/2023) and by the National Medical Ethics Committee (approval number 0120–105/2023/3). The study complied with the Declaration of Helsinki. Consent to participate: All patients signed an informed consent to participate in the study and to allow processing of their personal data. Competing interests: The authors declare no competing interests. Declaration of generative AI and AI-assisted technologies in the writing process: The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Number of patients reporting subjective change in financial capability: pre-disease versus post-disease
Fig. 2
Fig. 2
Number of patients reporting objective change in financial capability: pre-disease versus post-disease
Fig. 3
Fig. 3
The distribution of transport costs, based on those patients who provided a cost figure (n = 293)
See this image and copyright information in PMC

References

    1. Abrams HR, Durbin S, Huang CX et al (2021) Financial toxicity in cancer care: origins, impact, and solutions. Transl Behav Med 11(11):2043–2054 - PubMed
    1. Zafar SY, Abernethy AP (2013) Financial toxicity, Part I: a new name for a growing problem. Oncology (Williston Park) 27(2):80-1–149 - PMC - PubMed
    1. Tran G, Zafar SY (2018) Financial toxicity and implications for cancer care in the era of molecular and immune therapies. Ann Transl Med 6(9):166 - PMC - PubMed
    1. CANCER TODAY: Estimated number of new cases in 2020, World, both Sexex, all Ages (excl. NMSC) [internet]. Lyon: Cancer Today. Available at: https://gco.iarc.fr/today.
    1. Rak v Sloveniji 2020. Ljubljana: Onkološki inštitut Ljubljana, Epidemiologija in register raka. Register raka Republike Slovenije 2023.

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