Measuring Financial Distress and Quality of Life Over Time in Patients With Gynecologic Cancer-Making the Case to Screen Early in the Treatment Course
- 1 October 2021
- journal article
- research article
- Published by American Society of Clinical Oncology (ASCO) in JCO Oncology Practice
- Vol. 17 (10), 638-+
- https://doi.org/10.1200/OP.20.00907
Abstract
PURPOSE: Our objective was to measure the trajectory of financial distress and to determine its relationship with quality of life (QOL) among patients with cancer. MATERIALS AND METHODS: We conducted a longitudinal survey of patients with gynecologic cancer starting a new line of systemic therapy at baseline, 3 months, and 6 months. Financial distress was measured using a Comprehensive Score for Financial Toxicity (COST) < 26, and QOL was measured using Functional Assessment of Cancer Therapy-General (FACT-G) with lower scores indicating worse responses. One-way repeated analysis of variances, generalized estimating equation models, and correlation coefficients were used to evaluate financial distress and QOL over time. RESULTS: There were 90 of 121 (74%) baseline participants with a 6-month follow-up. The average age was 60 years, 29% were African-American, 57% had an annual income < $40,000 in US dollars, and 6% were uninsured. At baseline, 54% of patients screened positive for financial distress, which was unchanged at 3 months (50%, P = .27) but decreased at 6 months (46%, P = .04) compared with baseline. There was no change in average COST (23.6, 25.1, 25.6; P = .33) or FACT-G (70.8, 71.0, 72.8; P = .68) over time. Less financial distress was moderately correlated with better QOL (r = 0.63, 0.61, 0.60) at each time point. The presence of financial distress was associated with a 16-point decrease in FACT-G QOL score over time. CONCLUSION: Upfront screening with COST identified 90% of patients who experienced financial distress, and COST did not change significantly over time. More severe financial distress was moderately correlated with worse QOL, and its presence was associated with a clinically meaningful 16-point decrease in QOL.This publication has 18 references indexed in Scilit:
- Financial Hardships Experienced by Cancer Survivors: A Systematic ReviewJNCI Journal of the National Cancer Institute, 2016
- Measuring financial toxicity as a clinically relevant patient‐reported outcome: The validation of the COmprehensive Score for financial Toxicity (COST)Cancer, 2016
- Association of Financial Strain With Symptom Burden and Quality of Life for Patients With Lung or Colorectal CancerJournal of Clinical Oncology, 2016
- Self‐reported financial burden of cancer care and its effect on physical and mental health‐related quality of life among US cancer survivorsCancer, 2016
- Interventions to enhance return-to-work for cancer patientsCochrane Database of Systematic Reviews, 2015
- Financial Distress and Its Associations With Physical and Emotional Symptoms and Quality of Life Among Advanced Cancer PatientsThe Oncologist, 2015
- The development of a financial toxicity patient‐reported outcome in cancer: The COST measureCancer, 2014
- The impact of sociodemographic, treatment, and work support on missed work after breast cancer diagnosisBreast Cancer Research and Treatment, 2009
- Combining Distribution- and Anchor-Based Approaches to Determine Minimally Important DifferencesEvaluation & the Health Professions, 2005
- The Functional Assessment of Cancer Therapy scale: development and validation of the general measure.Journal of Clinical Oncology, 1993