Interventions to Reduce Financial Toxicity of Childhood, Adolescent, and Young Adult Cancer Survivors: A Scoping Review.
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Financial toxicity (FT) worsens health outcomes and quality of life for childhood, adolescent, and young adult (CAYA) cancer survivors. This scoping review examines interventions designed to alleviate FT among CAYA cancer survivors and identifies the levels of influence within the multilevel framework that these interventions target (i.e., patient, family/caregiver, provider, organization, policy, and society levels). Additionally, this review analyzes how current interventions align with National Comprehensive Cancer Network (NCCN) Recommendations for Supportive Care Services/Interventions for Socioeconomic Issues. We included English-language studies mentioning cost or adjacent terms that analyzed the effectiveness/efficacy of interventions designed to address FT in CAYA populations. Thirteen studies met the inclusion criteria. Most (n = 11, 84.6%) studies were conducted in the United States and addressed multiple levels of influence, primarily targeting the individual (n = 13, 100%), organizational (n = 7, 53.8%), and provider (n = 7, 53.8%) levels. Regarding NCCN recommendations, interventions most frequently addressed the integration of financial assistance into survivorship care plans (n = 8, 61.5%) and the establishment of financial support programs (n = 7, 53.8%). Extant literature focuses primarily on the individual level, financial assistance, and support programs. Future research should elucidate complex parameters defining multilevel interventions and prioritize gaps in current interventions according to NCCN guidelines.