Financial hardship in families of children or adolescents with cancer: a systematic literature review

In a new systematic review, scientists from the International Agency for Research on Cancer (IARC), St Jude Children’s Research Hospital (USA), and other partner institutions report that almost all families of children or adolescents with cancer experience financial hardship due to the cancer diagnosis, regardless of whether the family lives in a high-income country or a low- or middle-income country. The researchers also highlight difficulties in comparing adversities reported by the reviewed studies across contexts, and they propose a standardized approach to the collection and evaluation of reports of hardship, to promote the use of suitable, consistent, and comparable measures. The results of this systematic literature review were published in The Lancet Oncology.

The aim of this review was to synthesize the existing evidence on financial hardship of families dealing with childhood cancer worldwide. The researchers summarized how the prevalence of adversities resulting from unexpected care for a child or an adolescent with cancer is defined and measured globally. They also described the components that contribute to the financial hardship (i.e. medical costs and expenses required for various coping strategies and behaviours). Finally, they examined variations of the findings by country income level.

The researchers included 123 articles in their review, which enabled them to examine data from 47 countries. Although the lack of consistent measures limited direct comparisons, the available data indicated that the financial burden may impair vital functions of families in deprived contexts more often and to a larger extent than for families in affluent populations. The study team noted the scarcity of information on the experienced financial hardship of families in low- and middle-income countries.

Financial hardship experienced by affected families may hinder access to health care, can have long-term effects on the well-being of families, and is associated with poor health outcomes for both children with cancer and their family members. In 2018, the World Health Organization (WHO) launched the Global Initiative for Childhood Cancer, which explicitly denoted universal health coverage as a key priority to prevent financial hardship and reach the ambitious goal of reducing childhood suffering and increasing the survival rate of children with cancer globally to at least 60% by 2030. This study is part of the Targeting Childhood Cancer through the Global Initiative for Cancer Registry Development (ChildGICR) programme.

Ritter J, Allen S, Cohen PD, Fajardo AF, Marx K, Loggetto P, et al.
Financial hardship in families of children or adolescents with cancer: a systematic literature review
Lancet Oncol, Published online 29 August 2023;
https://doi.org/10.1016/S1470-2045(23)00320-0

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