Impact of Financial Toxicity on the Health-Related Quality of Life and Financial Well-Being of Cancer Patients and Survivors: A Comparative Study of the United Kingdom and United States.

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-01-01 DOI:10.1002/cam4.70606

Tran Thu Ngan, Emily Tonorezos, Michael Donnelly, Ciaran O'Neill

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引用次数: 0

Abstract

Background: This study investigated and compared the impact of financial toxicity (FT) on the health-related quality of life (HRQoL) and financial well-being of cancer patients and survivors in the United Kingdom (UK) and United States (US).

Methods: UK & US participants (n = 600) completed an online questionnaire that consisted of a validated FT instrument (COmprehensive Score for financial Toxicity-COST), a standardised HRQoL instrument (EQ-5D-5L) and questions related to their financial well-being. Tobit regression models and descriptive statistics plus χ² tests were used to analyse the association between FT and (i) HRQoL whilst controlling for sociodemographic characteristics; and (ii) financial well-being.

Results: In the UK, health utilities of participants with no assessed experience of FT, mild FT, and moderate/severe FT were 0.81, 0.66, and 0.41, respectively, compared to 0.88, 0.71, and 0.53 in the US. Among those with moderate/severe FT, US participants had significantly higher health utilities compared to their peers in the UK (Mann Whitney test, p = 0.0369). In a pooled analysis of UK and US and after controlling for sociodemographic and clinical characteristics, mild and moderate/severe FT was negatively associated with health utilities (β coff = -0.13, 95% CI: -0.18, -0.08 and β coff = -0.28, 95% CI: -0.34, -0.21, respectively). Over half (54%) of US participants with FT were in debt with median (IQR) debt at I$11,500 (23,000), compared to 32% in the UK with median (IQR) debt at I$ 7200 (12,960). US participants with FT were 2.48 times more likely to be in debt than UK participants with FT (OR = 2.48, 95% CI: 1.46-4.21).

Conclusions: FT is associated with poorer financial well-being and HRQoL among cancer patients/survivors in the US and UK. The impact of FT on financial well-being is larger in the US while the impact on HRQoL is worse in the UK. Further studies using prospective data are required to investigate the nature and extent of these relationships.

查看原文本刊更多论文

财务毒性对癌症患者和幸存者的健康相关生活质量和财务福利的影响：英国和美国的比较研究。

背景：本研究调查并比较了英国（UK）和美国（US）癌症患者和幸存者的财务毒性（FT）对健康相关生活质量（HRQoL）和财务状况的影响。方法：英国和美国的参与者（n = 600）完成了一份在线问卷，该问卷由一个经过验证的FT工具（金融毒性-成本综合评分）、一个标准化的HRQoL工具（EQ-5D-5L）和与他们的财务健康相关的问题组成。采用Tobit回归模型和描述性统计加χ2检验分析FT与(i) HRQoL之间的关系，同时控制社会人口统计学特征；（ii）财务状况良好。结果：在英国，没有评估过FT、轻度FT和中度/重度FT的参与者的健康效用分别为0.81、0.66和0.41，而在美国为0.88、0.71和0.53。在中度/重度FT患者中，美国参与者的健康效用显著高于英国参与者（Mann Whitney检验，p = 0.0369）。在英国和美国的汇总分析中，在控制了社会人口学和临床特征后，轻度和中度/重度FT与健康效用呈负相关（β coff = -0.13, 95% CI: -0.18, -0.08, β coff = -0.28, 95% CI: -0.34, -0.21）。超过一半（54%）的美国金融时报参与者负债，债务中位数（IQR）为11,500澳元（23,000澳元），而英国的这一比例为32%，债务中位数（IQR）为7200澳元（12,960澳元）。美国金融危机参与者负债的可能性是英国金融危机参与者的2.48倍（OR = 2.48, 95% CI: 1.46-4.21）。结论：在美国和英国，FT与较差的财务状况和癌症患者/幸存者的HRQoL有关。在美国，金融时报对财务状况的影响更大，而在英国，对生活质量的影响更糟。需要使用前瞻性数据的进一步研究来调查这些关系的性质和程度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.