Supportive Care in Cancer

, Volume 23, Issue 3, pp 889–898 | Cite as

The perceived cancer-related financial hardship among patients and their families: a systematic review

  • Meram AzzaniEmail author
  • April Camilla Roslani
  • Tin Tin Su
Review Article



The escalating health-care spending for cancer management has caused cancer patients to struggle further as a result of financial burden. This systematic review was carried out to investigate the prevalence of perceived financial hardship and associated factors among cancer patients and their families.


A systematic search for studies concerning the perception of financial burden among cancer patients and their families was conducted. Several electronic resources such as Medline, Elsevier (Science Direct), Web of Science, Embase, PubMed, CINAHL and Scopus (SciVerse) were searched. Additionally, manual search through indices citation was also thoroughly utilized. The main outcome of interest was the prevalence of perceived financial hardship among cancer patients and their families. Studies reported only the cost of cancer treatment and qualitative studies were excluded. Our search was limited to articles that were published from 2003 to 2013.


Ten studies were included in this review and with a majority originating from high-income countries. The prevalence of the financial burden perception was reported between 14.8 and 78.8 %. The most frequent and significant risk factor reported associated with the perception of financial difficulty was the households with low income. Discontinuation of treatment and poverty were conversely the important consequences of financial burden in cancer patients and their families.


Evidently, cancer is a long-term illness that requires a high financial cost, and a significant number of cancer patients and families struggle with financial difficulty. Identifying such groups with a high risk of facing financial difficulty is a crucial measure to ensure safety nets are readily available for these targeted population.


Financial hardship Cancer patient Cancer patient’s caregiver Systematic review 



The study was sponsored by Institute of Research Management and Monitoring (IPPP) of the University of Malaya; PG038-2013A and University of Malaya Research Grant RP004B-13HTM.

Conflict of interest


Author contribution

MA developed the search strategy and performed the literature search. MA and TTS performed the study selections and drafted the manuscript. ACR reviewed and edited the manuscript.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Meram Azzani
    • 1
    Email author
  • April Camilla Roslani
    • 2
    • 3
  • Tin Tin Su
    • 1
  1. 1.Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
  2. 2.University of Malaya Cancer Research Institute (UMCRI), Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
  3. 3.Department of Surgery, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia

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