ABSTRACT
PROFFIT (Patient Reported Outcome for Fighting FInancial Toxicity of cancer) questionnaire has been developed in Italy, within a universal healthcare system, for measuring financial toxicity (FT) in patients with cancer and understanding its determinants.
Our aim was to describe the amount of FT in patients with cancer, by using the PROFFIT questionnaire in subjects treated in a public Italian institution. Between May and July 2021 we administered, on one-off basis with a cross-sectional approach, the PROFFIT questionnaire to 167 outpatients receiving active anticancer treatment at the Oncology Day Hospital of Ordine Mauriziano Hospital, Turin, Italy. Answers were matched with relevant clinical and demographic characteristics.
Median FT score in the overall population was 23.81 (IQR 14.29-47.62). FT score was significantly higher in younger patients, in those with worse educational level, in private employees and unemployed, and in subjects with economically dependent familiars. No significant differences were found according to gender, time from diagnosis, type of tumor, type of treatment and disease setting. There was a significant association between FT score and the presence of economic damage due to COVID-19 for the patient or the family: median FT score was 14.29, 33.33 and 47.61 for those declaring no damage, a little damage and much damage (p < 0.001).
Our analysis, conducted during the COVID-19 pandemic, shows that financial toxicity is not negligible in patients with cancer, also in Italy, a country with universal healthcare system.

IMPACT STATEMENT 
We administered the PROFFIT questionnaire to 167 outpatients receiving active anticancer treatment at Mauriziano Hospital, Turin, Italy, showing that financial toxicity is not negligible in patients with cancer, also in a country with universal healthcare system.

SUPPLEMENTARY MATERIALS
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