[Financial Toxicity in Cancer Care-2026 Update].
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As cancer treatment advances, survival has improved with molecular-targeted drugs and immune checkpoint inhibitors; however, the economic burden on patients and families has become increasingly serious. "Financial toxicity" encompasses both objective financial burden and subjective financial distress from cancer diagnosis and treatment, affecting treatment continuity, medication adherence, quality of life, and prognosis. The 2024 "ESMO expert consensus statements on the screening and management of financial toxicity in patients with cancer" published by the European Society for Medical Oncology (ESMO) systematically recommended identification of high-risk patients, a sequential screening strategy, financial counseling by dedicated professionals, employment support, avoidance of low-value care, and protection of cancer survivors from insurance and financial discrimination. COmprehensive Score for financial Toxicity (COST) v2 (11 items, range 0-44) serves as the international standard assessment tool, with the Japanese version validated. In Japan, treatment abandonment due to financial reasons remains uncommon (1.8%), but 24.2% of all cancer patients-and 44.9% of adolescent and young adult (AYA) patients-reported that financial burden affected their daily lives (Patient Experience Survey, FY2023). Multidisciplinary teamwork incorporating standardized screening, social welfare support, employment assistance, and longitudinal monitoring is essential. A paradigm shift toward value-based cancer care, as advocated by Common Sense Oncology, is urgently needed in 2026.