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Poster Display session 3

2637 - Measuring financial toxicity of cancer in the Italian health care system: initial results of the patient reported outcome for Fighting Financial Toxicity of cancer project (proFFiT).


30 Sep 2019


Poster Display session 3


Bioethical Principles and GCP

Tumour Site


Silvia Riva


Annals of Oncology (2019) 30 (suppl_5): v671-v682. 10.1093/annonc/mdz263


S. Riva1, M. Di Maio2, F. Efficace3, L. Frontini4, C. Gallo5, D. Giannarelli6, V. Montesarchio7, F. De Lorenzo8, L. Del Campo8, E. Iannelli9, F. Traclò10, L. Gitto11, C. Jommi12, C.M. Vaccaro13, J.C. Bryce14, A. Gimigliano14, L. Sparavigna14, F. Perrone14

Author affiliations

  • 1 Science And Engineering, University of Wolverhampton, WV1 1LY - Wolverhampton/GB
  • 2 Dipartimento Di Oncologia, Università degli Studi di Torino, 10128 - Torino/IT
  • 3 Research, Fondazione GIMEMA Onlus, 00182 - Roma/IT
  • 4 Research, Fondazione GISCAD, 20122 - Milan/IT
  • 5 Statistica Medica, Università della Campania Luigi Vanvitelli, 80100 - Napoli/IT
  • 6 Biostatistical Unit, Regina Elena National Cancer Institute, 00144 - Rome/IT
  • 7 Oncologia, Azienda Ospedaliera Dei Colli-Monaldi, 80131 - Napoli/IT
  • 8 Favo, Federazione Italiana Delle Associazioni Di Volontariato In Oncologia, 00187 - Roma/IT
  • 9 Secretary, AIMaC - Associazione Italiana Malati di Cancro, 00187 - Rome/IT
  • 10 Research, AIMaC - Associazione Italiana Malati di Cancro, 00187 - Roma/IT
  • 11 Dipartimento Di Economia, Università degli Studi di Messina, 98122 - Messina/IT
  • 12 Practice, Government, Health And Not For Profit Division, SDA Bocconi School of Management, 20136 - Milano/IT
  • 13 Area Welfare E Salute, Centro Studi Investimenti Sociali (CENSIS), 00199 - Roma/IT
  • 14 Clinical Trial Unit, Istituto Nazionale Tumori - IRCCS - Fondazione Pascale, 80131 - Napoli/IT


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Abstract 2637


Financial toxicity in cancer patients has been initially reported in the United States and subsequently in other countries, including Italy, despite a health care system grounded on universal coverage. Considering that the way healthcare and welfare systems are shaped does impact on financial problems faced by cancer patients, we are developing an instrument for evaluating occurrence, gravity, and consequences of financial toxicity in Italy, and hopefully for fighting it.


Concept elicitation, item generation and qualitative analyses represented the initial tasks of the project. Literature review, focus groups with 34 cancer patients or caregivers in three regions located in North, Central, and South Italy, and semi-structured interviews with 97 oncologists were conducted for concept elicitation. A recursive process was used to identify themes in the data to inform the instrument until saturation was reached. Importance analysis questionnaires were administered to a further 44 cancer patients to evaluate and revise the draft item pool. A multi-disciplinary committee (including oncologists, psychologists, statisticians, patient association’s representatives, nurses, social science researchers and economists) oversaw the project.


Overall, 156 concepts were distributed among 10 themes (bureaucracy, medical care, domestic economy, emotion, family, job, health workers, welfare state, free time, transportation). After controlling for redundancy, 55 candidate items were generated and 30 items, with at least one per each theme, remained after importance analysis. Out of the 30 items, 23 (77%) refer to material conditions, 4 (13%) to psychological response, and 3 (10%) to coping behaviors.


The first results of the proFFiT project show that most of the items selected by patients are related to material conditions that cause, or derive from, financial hardship. The final questionnaire will be ready by the end of 2019. Supported by Fondazione AIRC IG grant 2017-20402.

Clinical trial identification


Editorial acknowledgement

Legal entity responsible for the study

Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione Pascale IRCCS, Naples, Italy.


Fondazione AIRC IG grant 2017-20402.


S. Riva: Honoraria (self): CSL-Behring; Honoraria (self): GlaxoSmithLine Foundation. M. Di Maio: Honoraria (self): BMS; Honoraria (self): MSD; Honoraria (self): Roche; Honoraria (self): AstraZeneca; Honoraria (self): Janssen. F. Efficace: Honoraria (self): BMS; Honoraria (self): Incyte; Honoraria (self): Orsenix; Honoraria (self): Amgen. V. Montesarchio: Honoraria (self): BMS; Honoraria (self): Italfarmaco; Spouse / Financial dependant: Bayer. F. Perrone: Honoraria (self): AstraZeneca; Honoraria (self): Bayer; Honoraria (self): Celgene; Honoraria (self): Incyte; Honoraria (self): Janssen-Cilag; Honoraria (self): Pierre Fabre; Honoraria (self): Sandoz. All other authors have declared no conflicts of interest.

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