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Erschienen in:
18.04.2020 | Epidemiology
Financial toxicity and its associated patient and cancer factors among women with breast cancer: a single-center analysis of low-middle income region in China
Erschienen in: Breast Cancer Research and Treatment | Ausgabe 2/2020
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Purpose
To assess the financial toxicity (FT) and to investigate patients and cancer characteristic that associated with it in patients admitted in a tertiary hospital in central China.
Methods
This was a cross-sectional study of 166 patients from 188 with stage 0-III women breast cancer admitted in Bethune hospital in Taiyuan, Shanxi province during January–May 2019. FT was self-reported using of financial Toxicity Comprehensive Rating Scale (COST-FACIT). Patients’ sociodemographic factors, clinical examination, and cancer treatment were collected from questionnaire and hospital record. The financial concern and coping strategy was self-reported. Factors associated with FT were identified using linear regression analysis.
Results
Of the 166 completed the survey, the COST score ranged 0–40 with a mean of 21.2 (median 22.5, standard deviation 8.1). On multivariate linear regression analysis, older age (β coefficient: 0.20, 95% CI 0.11–0.29, p < 0.001), higher household income (β coefficient: 3000–5000 Yuan: 7.88, 95% CI 4.74–11.01, p < 0.001; ≥ 5000 Yuan: 12.81, 95% CI 9.54–16.08, p < 0.001) were positively associated with COST scores. Advanced cancer stage was the strongest predictor of FT among the cancer characteristics (β coefficient: − 4.52, 95% CI − 7.13–1.92, p = 0.001). To cope with the FT, 131 (78.8%) patients decreased non-medical expenses, and 56 (33.7%) reduced or quitted treatment.
Conclusions
FT was significantly associated with patient’s age, income, and cancer stage. Women having financial concerns after diagnosis were more likely to reduce their non-medical expenses and even quit treatments. Clinicians should take into account the FT levels in all patients and work out appropriate treatment strategies for optimal clinical outcome.