Skip to main content
. Author manuscript; available in PMC: 2019 May 17.
Published in final edited form as: Gynecol Oncol. 2018 May 31;150(1):3–6. doi: 10.1016/j.ygyno.2018.05.012

Table 1:

Financial toxicity screening instruments

Instrument Screening question(s) Potential responses
National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List17 Please circle the number (0-10) that best describes how much distress you have been experiencing in the past week including today.

Please indicate if any of the following has been a problem for you in the past week including today.
0 (no distress) to 10 (extreme distress)

Under Practical Problems:
Child Care, Housing, Insurance/financial, Transportation, Work/school, Treatment decisions
Behavioral
Risk Factor Survey18
In the last 12 months, was there a time when you needed to see a doctor but could not because of cost? Yes
No
Medical Expenditure Panel Survey19 In the last 12 months, did you skip medications to save money? Yes
No
Aldana & Liljenquist20 Please indicate how often this describes you: I don’t have enough money to pay my bills. Never
Rarely
Sometimes
Often
Always
Organization for Economic Cooperation and Development (OECD) Measuring Financial Literacy21 Sometimes people find that their income does not quite cover their living costs. In the last 12 months, has this happened to you? Yes
No
Don’t Know
Comprehensive Score for Financial Toxicity (COST)22
I know that I have enough money in savings, retirement, or assets to cover the costs of my treatment.

My out-of-pocket medical expenses are more than I thought they would be.

I worry about the financial problems I will have in the future as a result of my illness or treatment.

I feel I have no choice about the amount of money I spend on care.
I am frustrated that I cannot work or contribute as much as I usually do.

I am satisfied with my current financial situation.

I am able to meet my monthly expenses.

I feel financially stressed.

I am concerned about keeping my job and income, including work at home.

My cancer or treatment has reduced my satisfaction with my present financial situation.

I feel in control of my financial situation.
Not at all
A little bit
Somewhat
Quite a bit
Very much

COST score <26 proposed as threshold for severe financial toxicity