■类似于癌症治疗的副作用,金融毒性(FT)会影响患者的生活质量,在肿瘤学领域引起了越来越多的关注。尽管广泛报道了FT的估计患病率和风险因素,这些结果尚未合成。
■本综述旨在系统地评估自我报告的FT的患病率和危险因素。
■系统评价和荟萃分析。
■使用PubMed的数据库对英语文献进行了计算机搜索,EMBASE,WebofScience,PsycINFO,和CINAHL,2010年1月至2021年9月期间,还包括了合格文章的参考列表。包括使用主观测量报告FT患病率或危险因素的观察性研究。
系统评价以系统评价和荟萃分析(PRISMA)声明的首选报告项目为指导。通过NIH观察队列和横断面研究质量评估工具评估偏倚风险。数据由两名审阅者提取,并在描述性表格中列出以进行荟萃分析。
■在可用于FT合并患病率荟萃分析的22项研究中,估计结果为45%(95%CI:38%至53%,I2=97.3%,P<0.001)基于随机效应模型。汇总分析确定了9个潜在的FT风险因素(β为7,OR为8):低收入(OR=2.48,95%CI:1.72至3.24,I2=3.1%,P<0.001),较大的年度OOP(β=-4.26,95%CI:-6.95至-1.57,I2=0%,P=0.002),年龄较小(OR=2.05,95%CI:1.56至2.54,I2=0%,P<0.001),没有私人保险(OR=1.69,95%CI:1.02至2.37,I2=0%,P<0.001),未婚(OR=1.10,95%CI:0.95至1.25,I2=53.3%,P<0.001),非白色(OR=1.59,95%CI:1.33至1.85,I2=0%,P<0.001),晚期癌症(β=-4.74,95%CI:-6.90至-2.57,I2=0%,P<0.001),失业(β=-2.90,95%CI:-5.71至-0.63,I2=75.7%,P<0.001),最近的诊断(OR=1.31,95%CI:1.04至1.57,I2=0%,P<0.001)。
■这项系统评价报告了自我报告的FT的合并患病率为45%。低收入,年度OOP(自掏腰包),年龄较小,未婚,失业,非白色,没有私人保险,晚期癌症,最近的诊断构成了自我报告FT的危险因素。对FT危险因素的研究可为医务人员评估和干预癌症幸存者的FT提供理论依据。
UNASSIGNED: Similar to the side effects of cancer treatment, financial toxicity (FT) can affect the quality of life of patients, which has attracted increasing attention in the field of oncology. Despite the fact that the estimated prevalence and risk factors of FT are widely reported, these results have not been synthesized.
UNASSIGNED: This
review is aimed to systematically assess the prevalence and risk factors of self-reported FT.
UNASSIGNED: Systematic
review and meta-analyses.
UNASSIGNED: A computer search of English literature was conducted using databases of PubMed, EMBASE, Web of Science, PsycINFO, and CINAHL, and reference lists of the qualified articles were also included between January 2010 and September 2021. Observational studies that reported the prevalence or risk factors of FT using subjective measures were included.
UNASSIGNED: The systematic
review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The risk of bias was assessed by the NIH observational cohort and cross-sectional study quality assessment tool. The data were extracted by two reviewers and listed in a descriptive table for meta-analyses.
UNASSIGNED: In the 22 studies available for meta-analyses of pooled prevalence of FT, the result was estimated to be 45% (95% CI: 38% to 53%, I2 = 97.3%, P < 0.001) based on a random-effects model. The pooled analysis identified 9 potential risk factors of FT (7 in β and 8 in OR): low income (OR = 2.48, 95% CI: 1.72 to 3.24, I2 = 3.1%, P < 0.001), greater annual OOP (β = -4.26, 95% CI: -6.95 to -1.57, I2 = 0%, P = 0.002), younger age (OR = 2.05, 95% CI: 1.56 to 2.54, I2 = 0%, P < 0.001), no private insurance (OR = 1.69, 95% CI: 1.02 to 2.37, I2 = 0%, P < 0.001), unmarried (OR = 1.10, 95% CI: 0.95 to 1.25, I2 = 53,3%, P < 0.001), nonwhite (OR = 1.59, 95% CI: 1.33 to 1.85, I2 = 0%, P < 0.001), advanced cancer (β = -4.74, 95% CI: -6.90 to -2.57, I2 = 0%, P < 0.001), unemployed (β = -2.90, 95% CI: -5.71 to -0.63, I2 = 75,7%, P < 0.001), more recent diagnosis (OR = 1.31, 95% CI: 1.04 to 1.57, I2 = 0%, P < 0.001).
UNASSIGNED: This systematic
review reported a pooled prevalence of self-reported FT of 45%. Low income, greater annual OOP (Out of pocket), younger age, unmarried, unemployed, nonwhite, no private insurance, advanced cancer, and more recent diagnosis constituted risk factors for self-reported FT. The research on risk factors for FT can provide a theoretical basis for medical staff to evaluate and intervene in the FT among cancer survivors.