{"title":"The Financial Toxicity of Hepatopancreatobiliary Cancer: An Analysis of the 1997-2023 National Health Interview Survey.","authors":"Thomas B Cwalina, David X Zheng","doi":"10.1007/s12029-025-01217-9","DOIUrl":null,"url":null,"abstract":"<p><p>Patients with hepatopancreatobiliary (HPB) cancers may experience financial toxicity as a result of diagnosis and treatment. We characterized the prevalence and predictors of financial toxicity among United States (U.S.) HPB cancer patients using the National Health Interview Survey. Outcomes were delaying medical care due to cost or being unable to afford necessary medical care within the past 12 months. Prevalence was estimated in univariable analyses and sociodemographic predictors were identified in multivariable analyses. Among 5,630,270 U.S. adults with self-reported HPB cancer, 567,531 (10.1%) delayed medical care due to cost and 474,632 (8.4%) were unable to afford necessary medical care within the past 12 months. Uninsured patients were more likely to delay care due to cost (aOR 14.38, 95% CI 4.81-43.01) or to be unable to afford necessary medical care (aOR 19.93, 95% CI 6.45-61.55). Non-White race (aOR 2.01, 95% CI 1.06-3.81) was a risk factor for delaying care due to cost, whereas household income < 200% of the federal poverty level (aOR 2.69, 95% CI 1.20-6.04) was associated with inability to afford necessary medical care. Patients who had received surgery within the past 12 months were not at higher odds of either financial toxicity outcome. Targeted interventions to mitigate financial toxicity among at-risk patients are warranted to alleviate the financial burden of HPB cancer care.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"92"},"PeriodicalIF":1.6000,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12029-025-01217-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Patients with hepatopancreatobiliary (HPB) cancers may experience financial toxicity as a result of diagnosis and treatment. We characterized the prevalence and predictors of financial toxicity among United States (U.S.) HPB cancer patients using the National Health Interview Survey. Outcomes were delaying medical care due to cost or being unable to afford necessary medical care within the past 12 months. Prevalence was estimated in univariable analyses and sociodemographic predictors were identified in multivariable analyses. Among 5,630,270 U.S. adults with self-reported HPB cancer, 567,531 (10.1%) delayed medical care due to cost and 474,632 (8.4%) were unable to afford necessary medical care within the past 12 months. Uninsured patients were more likely to delay care due to cost (aOR 14.38, 95% CI 4.81-43.01) or to be unable to afford necessary medical care (aOR 19.93, 95% CI 6.45-61.55). Non-White race (aOR 2.01, 95% CI 1.06-3.81) was a risk factor for delaying care due to cost, whereas household income < 200% of the federal poverty level (aOR 2.69, 95% CI 1.20-6.04) was associated with inability to afford necessary medical care. Patients who had received surgery within the past 12 months were not at higher odds of either financial toxicity outcome. Targeted interventions to mitigate financial toxicity among at-risk patients are warranted to alleviate the financial burden of HPB cancer care.
期刊介绍：
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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