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 |