Meta-analysisindependent cross-checkabstract checked I-CHM-116 standard review

Cancer costs push many patients into financial hardship

The financial toxicity of cancer: unveiling global burden and risk factors - a systematic review and meta-analysis.

Overview

Kitaw TA et al.. BMJ Glob Health 2025 · PMID 39929536 · DOI 10.1136/bmjgh-2024-017133

More than half of cancer patients in the pooled studies faced catastrophic health costs.

Does the study support the specific claim? Yes · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: Estimate global financial hardship from cancer
How was the study done?: Meta-analysis of 35 studies
How many people, animals or samples were studied?: 428,373 patients
What was actually found?: 56% catastrophic expenditure
How large was the observed effect?: 56.1% (48.3-63.8)
What do the results mean in everyday life?: Cost is a real burden that can lead to skipped care
What are the study's limitations?: Varied definitions
What does it say about Elawady's specific claim?: Supports the claim
Do the results apply to Germany and Europe?: Moderate
What can explicitly not be concluded from this study?: Does not mean treatment should be refused

Authors: Kitaw TA et al.
Journal: BMJ Glob Health
Year: 2025
Identifier: PMID 39929536 DOI 10.1136/bmjgh-2024-017133
Verification: verified – PubMed efetch 2026-10-26 (PublicationType and CommentsCorrections checked); Crossref 2026-10-26
Retracted: no
Corrections: none
Extent checked: abstract only
Conflicts of interest and funding: Not stated in abstract.

What is the global prevalence of catastrophic health expenditure among patients with cancer and its risk factors?

Study design: Meta-analysis – Systematic review and random-effects meta-analysis of observational studies
Population: Patients with cancer worldwide
Country: Global
Period: Not stated in abstract
Sample size: 35 studies, 428,373 patients
Inclusion and exclusion criteria: Peer-reviewed observational studies

Exposure / intervention: Cancer care costs
Comparator: Not applicable
Endpoints: Catastrophic health expenditure (CHE)
Statistical methods: Random-effects pooling; JBI appraisal; meta-regression; Egger/Begg tests

Results: Pooled CHE prevalence 56.1% (95% CI 48.3-63.8). Risk factors: large family size, low income, lack of health insurance, longer disease duration, older age, multiple treatments; higher education protective.
Absolute risks: 56.1% of patients face catastrophic health expenditure
Authors' conclusion: Over half of patients with cancer face catastrophic health expenditure; expanding insurance and financial support is needed.

CI symmetric on the proportion scale (stats/C-CHM-08.py).

Supports that financial toxicity is common worldwide, especially without insurance; extends the US pilot finding (A-CHM-19).

None.

Lower in countries with universal coverage (implied by insurance as risk factor).

Financial toxicity is a real, global problem.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	some concerns
Precision of results	moderate
Directness	direct
Reproducibility	unknown
Consistency with the overall evidence	consistent
Regional transferability	moderate
Adequacy of the interpretation (by the archive)	not applicable

Egypt-specific prevalence.