The following article features coverage from the 2021 ASCO Quality Care Symposium. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Preliminary data from a program that systematically screened patients for financial status indicated that financial hardship was prevalent among many patients with cancer. These findings were presented during the 2021 ASCO Quality Care Symposium.

Financial toxicity has been associated with poorer quality of life and earlier mortality. Researchers from Columbia University Medical Center in New York, New York, implemented a routine screening program in March 2021 using electronic health records (EHR). Patient advocates developed the systematic screening process, which used 2 questions from the Comprehensive Score for Financial Toxicity (COST) tool:

  • “I know that I have enough money in savings, retirement, or assets to cover the costs of my treatment.”
  • “I worry about the financial problems I will have in the future as a result of my illness or treatment.”

At the breast oncology clinic, 1358 patients who were due to undergo financial screening were flagged in the EHR system and asked to respond to the 2 questions through the online patient portal or on paper at check-in. Patient responses were entered into the EHR during assessment of their vital signs.

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A total of 526 patients responded to question 1, more than half of whom (53%) indicated they had financial hardship. For question 2, 532 patients responded and 40% said they were worried about the future of their finances because of their illness.

The clinicians found the implementation of the systematic screening difficult on more busy days and struggled with providing and collecting the paper forms. Despite this, preliminary findings suggested that many patients were experiencing financial toxicity.

The study authors plan to conduct focus groups among patients and clinicians to find out how best to improve financial outcomes for patients and optimize the systematic screening program.

Disclosure: Some study authors declared affiliations with biotechnical, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Read more of Oncology Nurse Advisor’s coverage of the 2021 ASCO Quality Care Symposium by visiting the conference page.


Beauchemin MP, Elkin EB, Wright JD, Kukafka R, Hershman DL, Kahn J. Incorporating systematic financial screening into the electronic health record. J Clin Oncol. 2021;39(suppl 28):abstr 184. doi:10.1200/JCO.2020.39.28_suppl.184