Table 3.

Summaries of included studies’ key findings (studies published after 2010)

Author Year	Objectives (aspects investigated)	Study design	Pop	Outcomes					Key findings: (a) Financial well-being, (b) Benefits/Welfare, (c) Mental health, (d) Employment, (e) HRQoL
				a	b	c	d	e
Brooks 201115	Additional expenses related to cancer	Rev		x		x			a + c. Money worries increased for 68.3% families after diagnosis. Lone parents more likely to report money worries
Elliott 201124	Self-reported health and well-being	Quan	S	x		x			a. 15–18% of cancer survivors were in debt but not worried about it a + c. 12–14% of cancer survivors with were in debt and worried about it
Young Lives vs Cancer 201139	Additional costs facing families, how a cancer diagnosis disrupts their employment and ability to earn income, what financial support is available, and how families cope with these various impacts	Mixed	P + S + C	x		x			a + c. The number of parents who said that money was ‘often’ or ‘frequently’ a worry increased 8-fold after diagnosis, from 8% to 65%. 76% families said that childhood cancer had been a ‘big problem’ for their finances.
Amir 201235	Effects of cancer’s related financial hardship/worries on family life (i.e. financial concerns of people affected by cancer)	Qual	P + C	x		x	x		a. Loss of income, especially for patients were in paid employment or self-employed at the time of diagnosis. Less or no impact on income of retired participants. Spend of savings, selling of possessions, altering usual activities and enjoyment of life to cope with loss of income c. Occurrence of negative emotions such as regret, disappointment, and self-reproach could lead to coexisting health problems and other difficulties. Family stress/strife, breakdown of relationships/families were other psychosocial facing patients and carers d. Return to work prematurely due to financial commitments. Concerns about job loss, employability, and lack of promotion.
Callanan 201223	Benefits and allowances that families may be entitled to claim	Commentary		x	x				a. Increased financial burden due to loss of income and increased costs for special diet, new clothing, heating, travel, and car parking b. Financial support from state welfare benefit system were needed the most by people with limited or no income
Moffatt 201216	Impact of welfare rights advice services on the quality of life and wellbeing of people with cancer	Mixed	P + C		x	x			b. Welfare benefits helped offset additional costs associated with cancer c. Receiving welfare benefits reduced levels of stress and anxiety related to financial difficulties.
Rogers 201217	Financial burden of having head and neck cancer, and its relation with health-related quality of life (HRQoL)	Quan	P	x	x				a. 54% patients experienced at least one moderate or large financial burden. Greater financial difficulty due to loss of income. Younger people were more likely to experience financial difficulty b. 39% patients applied for benefits. Of those applied, 71% had received it. Patients in working age and men were more likely to apply for benefits
Rogers 201218	Need for financial benefits, the advice patients were given about benefits and financial matters, and the financial burden of the disease	Quan	P	x	x			x	a. 57% reported that they were suffering financial hardship due to change in income b. 63% claimed that they need benefits. Unemployed (91%), part-time employed (71%), and those whose work was affected by cancer (75%) were more likely to need benefits. e. Decreased HRQoL (53%) as a result of the financial impact
Gardiner 201327	Financial costs and the financial impact of caring for family members receiving palliative/end-of-life care	Sys rev		x	x				Included results from Hanratty et al. (2007)
Macmillan Cancer Support 201338	Financial impact cancer is having on people across the UK	Mixed	P + S	x					a. 83% people are financially affected. The household was on average £570 a month worse off. Key factors that negatively influenced the severity of financial hardship were younger age (<60 years old), undergone chemotherapy and/or surgery, self-employed or part-time employed, and low income
McGarry 201330	Unmet supportive needs of people with breast cancer attending a London NHS Foundation Trust Hospital	Mixed	P	x	x	x			a. 17% of participants had concerns about finance (e.g. difficulties with rent and bills) due to inability to work or reducing of working hours b. Support from the system was insufficient to meet patient’s need and they had to depend on family for additional support c. Financial concerns added to overall stress during treatment
Azzani 201522	Prevalence of perceived financial hardship and associated factors	Sys rev		x	x				Included results from Rogers et al. (2012) ‘impact’
Moffatt 201519	Connections between cancer and employment; specifically, decisions, choice and constraints around returning to work or remaining outside the labor force	Qual	P	x	x	x			a. Affect household finances due to significant drop in income. Coping strategies are using savings, borrowing cash, cut on household expenditure, and selling property b. Claiming welfare, even for a cancer-related illness, is stigmatizing. c. It was stressful due to concern over the impact of cancer on financial situation, future employment prospects, and families’ life
Pelletier 201531	Family financial burden in childhood cancer	Sys rev		x	x	x			Included results from Eiser et al. (2006)
Young Lives vs Cancer 201640	Additional costs facing young cancer patients and their families; how a cancer diagnosis is disrupting the employment and income; emotional impact of the financial burden of cancer	Mixed	P + C	x	x	x			a. Parents spent £600 extra per month during active treatment of their children. For young patients, it was £360/month. Great financial pressure: 61% had built up debt and 17% borrowed over £5000 b. Forms to apply for Disability Living Allowance and Personal Independence Payment was long and stressful to complete, and patients often required help to fill out (84%) c. 76% of parents and 54% of young people reported additional stress and anxiety while managing their finances during treatment
Macmillan Cancer Support 201737	Financial impact of cancer		P + S	x		x		x	a. 39% of people with cancer have used savings, sold assets or borrowed to cover the costs or the loss of income caused by their diagnosis. 30% carers reported that their income or household finances were affected by caring c. 53% reported feeling more anxious or stressed. 37% said it had made them feel more isolated or alone e. Negatively affected quality of life (61%)
Watson 201933	Care experiences and supportive care needs	Quan	P	x					a. Negatively impacted on day-to-day financial situation (51%)
Flaum 202026	FT and financial burden	Quan	P	x					a. Prevalence of FT among surveyed cancer patient was reported at 20%
Zhu 202034	Cancer survivors’ experiences with FT	Sys rev		x		x	x		Included results from Amir et al. (2012)
Lu 202120	Association between levels of financial stress and cancer-related fatigue (CRF)	Quan	S			x			c. 11% survivors reported both pre- and post-diagnosis financial stress (cumulative stress). Survivors with cumulative financial stress exposure were significantly more likely to have CRF (Odds ratio (OR) = 4.58, 95% CI 3.30–6.35, P < 0.001), compared with those without financial stress.
Fitch 202225	Cancer-related FT or burden	Sys rev		x	x	x	x		Included results from Moffatt et al. (2010), Moffatt et al. (2012) and Amir et al. (2012)

Study design—Mixed: Mixed methods, Qual: Qualitative research, Quan: Quantitative data, Rev: Narrative review, Sys rev: Systematic review.

Pop: Studies population—C: Carers/family members, P: Patients, S: Survivors.