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Patients with Colorectal Cancer Report High Financial Burden
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Most respondents to a newly developed patient-reported measure of personal financial burden associated with stage III colorectal cancer reported having financial burden, especially those who underwent adjuvant chemotherapy.
“Almost 50,000 patients are diagnosed with stage III colorectal cancer (CRC) every year in the United States, and we know that chemotherapy can increase survival by up to 20% for these patients,” Christine M. Veenstra, MD, MSHP, department of internal medicine, division of hematology/oncology, University of Michigan, told Healio Gastroenterology. “But we also know that chemotherapy might be associated with financial strain for these patients, so we wanted to better understand the financial burden and worry associated with CRC treatment.”
Christine M. Veenstra
Veenstra and colleagues performed a population-based survey of 1,653 patients with stage III CRC identified using SEER registry data from Detroit and Georgia from August 2011 to March 2013. The primary goal was to develop a patient-reported measure of personal financial burden in a diverse population, and the secondary goal was to evaluate the association between chemotherapy and financial burden among this population. Using factor analysis of survey results, they created a 6-point scale.
“Not unexpectedly, financial burden and worry were highest among the patients who were getting chemotherapy,” Veenstra said. “Patients who were using chemotherapy were significantly more likely to endorse each item of financial burden [on the survey], and burden was notably highest of all in the younger, working, low-income patients.”
The mean financial burden score was 1.72 among the 66% of eligible patients who responded to the survey, and it was 1.88 for the 85% of patients using adjuvant chemotherapy compared with 0.88 for those who did not (P<.001). Financial burden scores of 1 to 2 accounted for 29% of respondents, scores of 3 to 4 accounted for 23% and scores of at least 5 accounted for 9%. Compared with those who did not receive chemotherapy, patients who did were more likely to use savings (36% vs. 21%; P<.001); borrow money or take out a loan (14% vs. 5%; P=.002); miss credit card payments (14% vs. 5%; P=.002); and cut down spending on food and clothing (33% vs. 15%; P<.001), recreation (39% vs. 16%; P<.001) or general expenses (57% vs. 26%; P<.01).
“One of the most important things to recognize is the financial burden our patients reported is experienced on top of everything else that they are going through with their CRC, so the financial burden is particularly hard on top of all of that,” Veenstra said. “We hope our findings will encourage clinicians and patients to talk about the financial burden because there are some financial supports available that might benefit patients undergoing treatment for cancer, but only if patients are aware that they exist.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.
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