Financial toxicity among cancer patients and survivors: a comparative study of the United Kingdom United States

Abstract Background The study investigated the experiences of financial toxicity (FT) among cancer patients/survivors in the United Kingdom (UK) & the United States (US). Methods 600 cancer patients/survivors residing in the UK (n = 319) or US (n = 281) completed an online cross-sectional survey using the COmprehensive Score for financial Toxicity (COST)-a validated measure of FT. Severity of FT was defined as ‘no’ (COST scores > = 26), ‘mild’ (14–25), and ‘moderate/severe’ (0–13). Results 34% of UK participants faced FT which was significantly lower compared to the US at 55% (crude OR = 2.44, 95%CI: 1.73–3.42). An ordered logistic regression model showed that in the US, being 65 + years old (adjusted OR = 0.19, 95%CI: 0.07–0.48), retired (aOR = 0.26, 95%CI: 0.09–0.75), and having a higher household income (aOR ranged 0.03–0.19) decreased the risk of FT while being female increased the risk (aOR = 1.83, 95%CI: 1.01–3.32). In the UK, age and sex did not have an effect but higher income and being retired showed an identical pattern compared to the US. Conclusions FT was less prevalent and less severe in the UK, compared to the US. The high prevalence of FT underscores the need to provide an additional level of protection to the most vulnerable groups than is currently offered in either country.