Association between financial toxicity and health-related quality of life of patients with gynecologic cancer

Yusuke Kajimoto, Kazunori Honda, Shiro Suzuki, Masahiko Mori, Hirofumi Tsubouchi, Kohshiro Nakao, Anri Azuma, Takashi Shibutani, Shoji Nagao, Takahiro Koyanagi, Izumi Kohara, Shuko Tamaki, Midori Yabuki, Lida Teng, Keiichi Fujiwara, Ataru Igarashi

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Objectives: Patients often struggle with their financial situation during cancer treatment due to treatment-related costs or loss of income. This resulting negative effect is called financial toxicity, which is a known as a side effect of cancer care. This study aimed to evaluate the association between financial toxicity and health-related quality of life among patients with gynecologic cancer using validated questionnaires. Methods: In this multicenter study, patients with gynecologic cancer receiving anti-cancer drug treatment for > 2 months were recruited. Patients answered the COmprehensive Score for Financial Toxicity (COST) tool, EORTC-QLQ-C30, disease-specific tools (EORTC-QLQ-OV28/CX24/EN24), and EQ-5D-5L. Spearman’s rank correlation coefficient was used to determine associations. Results: Between April 2019 and July 2021, 109 cancer patients completed the COST questionnaire. The mean COST score was 19.82. Strong associations were observed between financial difficulty (r = − 0.616) in the EORTC-QLQ-C30 and body image (r = 0.738) in the EORTC-QLQ-CX24, while weak associations were noted between the global health status/quality of life (r = 0.207), EQ-5D-5L index score (r = 0.252), and several function and symptom scale scores with the COST score. Conclusions: Greater financial toxicity was associated with worse health-related quality of life scores, such as financial difficulty in gynecologic cancer patients and body image in cervical cancer patients as strong associations, and weakly associated with general health-related quality of life scores and several function/symptom scales.

Original languageEnglish
Pages (from-to)454-467
Number of pages14
JournalInternational Journal of Clinical Oncology
Issue number3
Publication statusPublished - Mar 2023


  • Financial toxicity
  • Gynecology
  • Health care costs
  • Patient-reported outcome measures
  • Quality of life

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology


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