The relationship between financial toxicity and health-related quality of life in parents of children with cancer: A cross-sectional study

Purpose: Caring for children with cancer imposes substantial emotional, physical, and social burdens on parents, profoundly impairing their health-related quality of life (HRQoL). Financial toxicity (FT), resulting from cancer-related expenses, is a critical yet understudied determinant of well-being in this population. This study aimed to explore the relationship between FT and HRQoL in parents of children with cancer.

Methods: Employing a cross-sectional design, this study surveyed 318 parents of childhood cancer patients across three tertiary hospitals in China. Data were collected through a demographic questionnaire, the EQ-5D-5L profile, and the COmprehensive Score for financial Toxicity.

Results: FT was reported by 95.3% of parents, with a median score of 11.00 (IQR: 7.00 to 16.25). Lower levels of FT were significantly associated with higher EQ-5D-5L utility values (r = 0.483, p < 0.001) and better visual analog scale scores (r = 0.822, p < 0.001). Hierarchical regression demonstrated that FT independently explained an additional 3.8% of the variance in utility values (β = 0.246, p = 0.001) and 10.0% in visual analog scale scores (β = 0.498, p < 0.001).

Conclusions: FT emerged as a pervasive challenge for parents of children undergoing cancer treatment and was significantly associated with poorer HRQoL. Future studies should focus on designing and evaluating financial support efforts to alleviate FT and enhance HRQoL among this vulnerable population.

Practical implications: Routine FT assessments should be incorporated into supportive care for parents managing childhood cancer. Targeted financial policies and interventions are urgently needed to improve parental well-being.

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