PATIENT-REPORTED FINANCIAL TOXICITY AND HEALTH-RELATED QUALITY OF LIFE AMONG A MODERN POPULATION-BASED COHORT OF GEORGIA WOMEN DIAGNOSED WITH BREAST CANCER Pubblico

Adisa, Oyinda (Summer 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/j098zc426?locale=it
Published

Abstract

Background and purpose: Financial toxicity (FT) is the adverse impact of a cancer diagnosis on a patient’s well-being resulting from direct and/or indirect costs of cancer care, and breast cancer patients face the highest increases in national medical costs of continuing cancer care in the US than any other group. This study examined the significance of the association of several factors with patient-reported financial toxicity, some of which include age, race, employment status, education, insurance status, annual household income and chemotherapy status. The association between patient-reported FT and health-related quality of life (HRQoL) was also assessed. 

 

Methods: A total of 1063 women aged 20-79 years with newly diagnosed early-stage breast cancer (stages 0 to II) who were treated in 2014 and 2015 and identified through the Georgia Surveillance, Epidemiology, and End Results (SEER) registry were surveyed. Patient-reported FT was measured by asking respondents if their worsened financial situation resulted from their illness and was dichotomized into “yes” vs. “no.” HRQoL was measured by creating a 6-item composite score on participants’ general well-being and categorizing the score as low, moderate, and high. Multivariate associations between financial toxicity and HRQoL were reported. 

 

Results: FT was experienced by 42% of the respondents. Income at the time of diagnosis, lost income due to cancer, current insurance status, current debt due to cancer, and surgery status, were predictors found to be significantly associated with financial toxicity. Experiencing FT (OR = 0.51, 95% CI = 0.29 – 0.89) was also associated with being less likely to have a high HRQoL composite score. 

 

Conclusions: The significant association between FT and HRQoL exemplifies the urgent need for more awareness of FT. Little is known about the impact of patient-reported financial toxicity on health-related quality of life (HRQoL), and understanding it is necessary to create awareness amongst providers on the unique financial, mental and physical quality of life (QoL) challenges breast cancer patients face.

Table of Contents

ABSTRACT………………………………………………………………………………………ii 

ACKNOWLEDGMENTS……………………………………………………………………….iv 

LIST OF TABLES……………………………………………………………………………....vii

CHAPTER 1: INTRODUCTION .......................................................................................1

CHAPTER 2: METHODOLOGY ......................................................................................7

2.1 Methods ……………………………………………………………………………..7

2.1.1 Study Design, Data Source and Study Population……………………7

2.1.2 Data Collection……………………………………………………………8

2.1.3 Questionnaire Design and Content……………………………………..8

2.2 Measures ……………………………………………………………………………8

2.2.1 Sociodemographic and Disease/Treatment-related characteristics...8

2.2.2 Patient-reported Financial Toxicity (FT)………………………………..9

2.2.3 Health-related Quality of Life (HRQoL)………………………………...9

2.3 Statistical Analysis………………………………………………………………...10

CHAPTER 3: RESULTS ................................................................................................13

3.1 Respondents’ characteristics…………………………………………………….13

3.2 Prevalence of patient-reported financial toxicity (FT) and associated predictors……………………………………………………………………………….14

3.3 Associations of patient-reported FT with HRQoL……………………………...14

CHAPTER 4: DISCUSSION ..........................................................................................15

CHAPTER 5: CONCLUSIONS ......................................................................................17

REFERENCES ..............................................................................................................29

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