Many breast cancer survivors face worsening financial concerns over time
Click Here to Manage Email Alerts
More than one in seven breast cancer survivors reported persistent financial hardship within 5 years of diagnosis, according to study results.
Individuals with lower baseline financial security appeared to be particularly susceptible to this hardship, findings presented at this year’s American Association for Cancer Research Annual Meeting showed.
“Cancer treatment can really impact our patients financially in multiple ways: there is the cost of missed work, the cost of child care while undergoing treatment, and more. Many studies have looked cross-sectionally at financial hardship in [patients with breast cancer], but we were hoping to do more of a longitudinal study,” Michael H. Storandt, MD, resident in the division of community internal medicine, geriatrics and palliative care at Mayo Clinic in Rochester, Minnesota, told Healio. “At the Mayo Clinic, we have the Breast Disease Registry, where we survey breast cancer survivors at the time of diagnosis and annually thereafter. So, we have this great set of data to be able to look at how these patients rate their financial concerns over time.”
In the study, Storandt evaluated data on 1,957 patients (mean age, 58.5 years; standard deviation [SD], 12.5 years) from the prospective cohort who had been seen at Mayo Clinic within a year of breast cancer diagnosis. The participants responded to surveys at baseline and annually between 2015 and 2020, measuring their financial concerns on a linear analogue scale from 0 (“none”) to 10 (“constant concerns”). The researchers compared patient-reported financial concern at baseline with the most recent survey for each patient. They defined worsening concerns as a 1-point or greater increase, and used logistic regression to assess predictors of intensifying financial hardship.
Mean time between diagnosis and most recent survey was 25.6 months (SD, 16.2).
The researchers found 357 (18.2%) of patients reported worsening financial concerns, with lower baseline financial status as the only factor predictive of worsening financial difficulty.
Storandt said in the baseline survey, participants could characterize their financial concerns in terms of what they could afford. Categories included ability to pay bills with extra money for special things; ability to pay their bills but with no money for special things; ability to pay bills by making cuts, and ability to pay their bills even after making cuts.
The group that reported being able to pay bills but having nothing left over for special things at baseline was the only group whose worsening financial status attained statistical significance (P = .046).
“This would suggest that people who have a marginal financial status at baseline — who were on the cusp of financial hardship — were perhaps the most vulnerable,” Storandt told Healio. “It may suggest that we target certain groups when we think about financial toxicity, and that possibly, this is a group we have overlooked. They pay their bills, on time, they seem to be doing fine, but they may be on the brink of financial distress.”
Storandt said he would like to see this type of research conducted in less financially secure populations.
“This is something that needs to be investigated further,” he said. “I think it would be great to expand this out to other populations of patients, recognizing that our patients were seen at a tertiary medical center and were relatively financially stable at baseline.”
Perspective
Back to Top
These findings come as no surprise, as financial concerns and back-to-work issues have been reported previously. The implications for practitioners include giving them an awareness of the issue of financial hardship in breast cancer survivors so they can generate the appropriate referrals — for example, social work follow-up or mental health services.
Some unanswered questions remain. We need to know the risk factors for financial toxicity and whether early intervention could make a difference to patients. Next steps in this area are to conduct randomized clinical trials in which prospective interventions to reduce financial toxicity are tested.
Collapse
Storandt MH, et al. Abstract 1012. Presented at: American Association for Cancer Research Annual Meeting; April 8-13, 2022; New Orleans.
Click Here to Manage Email Alerts