Assessment of Financial Toxicity Among Patients With Advanced Lung Cancer in Western China

Abstract

Background: Lung cancer is the leading source of cancer-caused disability-adjusted life years. Medical cost burden impacts the well-being of patients through reducing income, cutting daily expenses, curtailing leisure activities, and depleting exhausting savings. The COmprehensive Score for Financial Toxicity (COST) was created and validated by De Souza and colleagues. Our study intends to measure the financial burdens of cancer therapy and investigate the link between financial toxicity and health-related quality of life (HRQoL) in an advanced lung cancer population.Methods: Patients aged ≥ 18 years with confirmed stage III to IV lung cancer were eligible. The COST questionnaire verified by de Souza et al. was used to identify financial toxicity. Multivariable linear regression analysis with log transformation univariate analysis and Pearson correlations were used to perform the analysis.Results: The majority of the patients (90.8%, n = 138/152) had an annual income of $50,000 ($7,775). The cohort's insurance situation was as follows: 64.5% of the cohort had social insurance, 20.4% had commercial insurance, and 22.0% had both. Patients who were younger age (50–59, P < 0.001), employed but on sick leave, and had lower income reported increased levels of financial toxicity (P < 0.05). The risk factors for high financial toxicity: (i) younger age (50–59), (ii) <1 month of savings, and (iii) being employed but on sick leave. Increased financial toxicity is moderately correlated with a decrease in QoL.Conclusion: Poorer psychological status and specific demographics are linked to increased financial toxicity (lower COST). Financial toxicity has a modest relationship with HRQoL and may have a clear link with HRQoL measurements.

Assessment of self-reported financial toxicity among patients with nasopharyngeal carcinoma undergoing radiotherapy: A cross-sectional study in western China

“…This is probably due to the fact that the economy of western China is less developed, thus resulting in lower overall income level compared with the east. Our findings in this study suggested that unemployed, no commercial insurance, receiving lower annual income, advanced cancer, and receiving targeted therapy were factors significantly associated with higher FT. Lower annual household income is one of the key risk factors of FT. We observed a substantial decrease in the probability of reporting FT in patients with annual household income above 200,000 CNY, which was consistent with the results of Xu and Jing et al that investigated FT in lung cancer and breast cancer patients respectively (27,28). The results of Yu et al found that patients with URBMI were associated with an average 2.2 point decrease in the COST scores compared to patients who had UEBMI (29).…”

Comprehensive Score for Financial Toxicity and Health-Related Quality of Life in Patients With Cancer and Survivors: A Systematic Review and Meta-Analysis

“…More longitudinal investigations are required to understand the dynamics of financial toxicity during the disease course and its impact on HRQOL. Interestingly, our included studies showed that the correlation strengths between financial toxicity and overall HRQOL were slightly stronger in studies that used English instruments (median = 0.53, range = 0.33-0.73) 57,58,60,62,64,66,73,81 than those in other languages, for example, Mandarin Chinese, Italian, and Arabic (median = 0.43, range = 0.34-0.52), 51,55,67,72,79,80 and conducted in countries with universal health coverage (median = 0.49, range = 0.34-0.73) 55,58,66,72,79,80 than those without (median = 0.42, range = 0.33-0.63). 51,57,60,62,64,67,73,81 Nevertheless, we had inadequate number of studies to further examine (eg, performing subgroup analysis) the potential impact of instrument language or universal health coverage on the association between financial toxicity and HRQOL.…”

Financial toxicity and psychological distress in adults with cancer: A treatment-based analysis

“… 6 Increasing research attention is being paid to the source and outcome of financial toxicity, and how best to identify and address this problem. 7 , 8 , 9 , 10 Psychological distress is conceptualized as a multifactorial, unpleasant experience of a psychological, social, spiritual, or physical nature that may interfere with the ability to cope effectively with the physical symptoms and treatment of cancer. 11 It has been considered the sixth vital sign, after pain, in cancer care.…”