The Socio-Demographic Factors Correlated with Financial Toxicity among Patients with Breast Cancer in Indonesia

Abstract

Background: Breast cancer is one of the major cancer types found among Indonesian women. This cancer diagnosis and its treatment causes perpetual financial burden for the women and their family. This study aims to identify the correlation between socio-demographics with financial toxicity among women with breast cancer in Indonesia.Design and methods: This study design was cross-sectional with 109 respondents of Indonesian breast cancer survivors who were recruited using consecutive sampling. Quantitative data were collected with a demographic and a Comprehensive Score for Financial Toxicity (COST) questionnaires, then analyzed using Chi-Square test and linear regression method.Results: The majority of the women were 18 to 55-years-old (75.2%), married (91.7%), employed (80.7%), and having moderate income (58.7%). Logistic regression analysis indicates that survivor’s family as a primary wage earner (p=0.042), low-high income (p=0.043), and dependents number (p=0.012) are significantly associated with financial toxicity.Conclusions: The financial toxicity among women with breast cancer was mainly correlated with the number of survivor’s dependent and the household income. This study encourage related parties to establish socio-economic safety net for women with breast cancer, including their families.

Financial toxicity assessment and associated factors analysis of patients with cancer in China

“…The patients in this study registered a median COST score of 18, more than 80% of patients with cancer reported at least moderate FT (COST score <26 [ 11 ]), and nearly one-third of them suffered from severe FT (COST score <14 [ 11 ]), lower than the 25.5 and 22.5 reported by other Chinese scholars [ 19 , 25 ]. Although previous studies focused on patients in a single center and with a single disease type, they also demonstrated very serious FT experienced by patients with cancer in China, and the incidence of FT was found to be higher than that of other developing countries [ 10 , 26 , 27 ]. Other related studies have found that characteristics such as rural residents [ 28 ], female [ 29 ], younger age [ 7 , 19 ], unemployment [ 4 , 11 ], marriage [ 27 , 30 ], lower educational level [ 11 , 31 ], and lower income [ 4 , 10 , 19 , 30 ] were associated with higher FT, but our results revealed that FT was independent of gender [ 31 ], marital status [ 26 ], and education [ 17 ].…”

“…Although previous studies focused on patients in a single center and with a single disease type, they also demonstrated very serious FT experienced by patients with cancer in China, and the incidence of FT was found to be higher than that of other developing countries [ 10 , 26 , 27 ]. Other related studies have found that characteristics such as rural residents [ 28 ], female [ 29 ], younger age [ 7 , 19 ], unemployment [ 4 , 11 ], marriage [ 27 , 30 ], lower educational level [ 11 , 31 ], and lower income [ 4 , 10 , 19 , 30 ] were associated with higher FT, but our results revealed that FT was independent of gender [ 31 ], marital status [ 26 ], and education [ 17 ]. Sociodemographic differences in FT were reflected in household residence type [ 27 ], medical insurance policies [ 4 , 7 , 32 ], and OOP medication expenditures which are consistent with existing studies, confirming that demographic risk factors are extensive.…”

“…However, our study did not address more common strategies, such as cutting spending on food, clothing, or leisure to cope with FT [ 18 ]. Multiple studies have shown that FT is associated with treatment interruption, poor medication compliance, and denial of needed care [ 18 , 43 ], and respondents with high FT were seven times more likely to delay or abandon treatment due to financial constraints [ 10 ], ultimately resulting in unfavorable survival and quality of life [ 2 , 36 ].…”

“…FT in patients with cancer is actually aggravating [ 10 ]. It was estimated that approximately 40–70% of patients with cancer would suffer from FT [ 11 ].…”

The Association between The Patient’s Age Groups with Stage, Grading, and Molecular Subtype of Breast Cancer

“…4 Breast cancer is one of the major health burdens in Indonesia. The burdens are different exposures to risk factors, economic settings, lifestyles, access to care and screening, 5 delay in seeking help and non-adherence 6 , financial toxicity, 7,8 , and Social Insurance Administration Organization reported that from 1,308,061 inpatient cancer cases treated in 2016, a total of 2.2 trillion rupiahs was spent, amounting to $486,960,633 in the US dollars (purchasing power…”