Financial Toxicity among Patients with Breast Cancer during the COVID-19 Pandemic in the United States

This study reported the prevalence of financial distress (financial toxicity (FT)) and COVID-19-related economic stress in patients with breast cancer (BC). Patients with BC were recruited from the Ciitizen platform, Breastcancer.org, and patient advocacy groups between 30 March and 6 July 2021. FT...

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Bibliographic Details
Main Authors: Yan Wu, Xianchen Liu, Martine C. Maculaitis, Benjamin Li, Alexandra Berk, Angelina Massa, Marisa C. Weiss, Lynn McRoy
Format: Article
Language:English
Published: MDPI AG 2023-12-01
Series:Cancers
Subjects:
Online Access:https://www.mdpi.com/2072-6694/16/1/62
Description
Summary:This study reported the prevalence of financial distress (financial toxicity (FT)) and COVID-19-related economic stress in patients with breast cancer (BC). Patients with BC were recruited from the Ciitizen platform, Breastcancer.org, and patient advocacy groups between 30 March and 6 July 2021. FT was assessed with the COmprehensive Score for financial Toxicity (COST) instrument. COVID-19-related economic stress was assessed with the COVID-19 Stress Scale. Among the 669 patients, the mean age was 51.6 years; 9.4% reported a COVID-19 diagnosis. The prevalence rates of mild and moderate/severe FT were 36.8% and 22.4%, respectively. FT was more prevalent in patients with metastatic versus early BC (<i>p</i> < 0.001). The factors associated with FT included income ≤ USD 49,999 (adjusted odds ratio (adj OR) 6.271, <i>p</i> < 0.0001) and USD 50,000–USD 149,999 (adj OR 2.722, <i>p</i> < 0.0001); aged <50 years (adj OR 3.061, <i>p</i> = 0.0012) and 50–64 years (adj OR 3.444, <i>p</i> = 0.0002); living alone (adj OR 1.603, <i>p</i> = 0.0476); and greater depression severity (adj OR 1.155, <i>p</i> < 0.0001). Black patients (adj OR 2.165, <i>p</i> = 0.0133), patients with income ≤ USD 49,999 (adj OR 1.921, <i>p</i> = 0.0432), or greater depression severity (adj OR 1.090, <i>p</i> < 0.0001) were more likely to experience COVID-19-related economic stress. FT was common in patients with BC, particularly metastatic disease, during COVID-19. Multiple factors, especially lower income and greater depression severity were associated with financial difficulties during COVID-19.
ISSN:2072-6694