Do discussions of financial burdens decrease long-term financial toxicity in adolescent and young adult cancer survivors? Journal Article
| Authors: | Wu, V. S.; Benedict, C.; Friedman, D. N.; Watson, S. E.; Anglade, E.; Zeitler, M. S.; Chino, F.; Thom, B. |
| Article Title: | Do discussions of financial burdens decrease long-term financial toxicity in adolescent and young adult cancer survivors? |
| Abstract: | Purpose: This study aims to evaluate the associations between patient-provider cost discussions with patient-reported out-of-pocket (OOP) spending and long-term financial toxicity (FT) among adolescent and young adult (AYA; 15–39 years old) cancer survivors. Methods: Using a cross-sectional survey, we assessed the themes and quality of patient discussions with providers about financial needs and general survivorship preparation, quantified patients’ levels of FT, and evaluated patient-reported OOP spending. We determined the association between cancer treatment cost discussion and FT using multivariable analysis. In a subset of survivors (n = 18), we conducted qualitative interviews and used thematic analysis to characterize responses. Results: Two hundred forty-seven AYA survivors completed the survey at a mean of 7 years post treatment and with a median COST score of 13. 70% of AYA survivors did not recall having any cost discussion about their cancer treatment with a provider. Having any cost discussion with a provider was associated with decreased FT (β = 3.00; p = 0.02) but not associated with reduced OOP spending (χ2 = 3.77; p = 0.44). In a second adjusted model, with OOP spending included as a covariate, OOP spending was a significant predictor of FT (β = − 1.40; p = 0.002). Key qualitative themes included survivors’ frustration about the lack of communication related to financial issues throughout treatment and in survivorship, feeling unprepared, and reluctance to seek help. Conclusion: AYA patients are not fully informed about the costs of cancer care and FT; the dearth of cost discussions between patients and providers may represent a missed opportunity to reduce costs. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. |
| Keywords: | adolescent; adult; cancer survival; clinical article; controlled study; young adult; neoplasm; neoplasms; cancer therapy; survivor; cancer survivor; survivors; quantitative analysis; clinical evaluation; survivorship; interview; cross-sectional study; cross-sectional studies; recall; cancer survivors; thematic analysis; cancer survivorship; frustration; humans; human; male; female; article; financial toxicity; aya; financial distress; financial stress; cost discussions |
| Journal Title: | Supportive Care in Cancer |
| Volume: | 31 |
| Issue: | 7 |
| ISSN: | 0941-4355 |
| Publisher: | Springer Verlag |
| Date Published: | 2023-07-01 |
| Start Page: | 434 |
| Language: | English |
| DOI: | 10.1007/s00520-023-07822-3 |
| PUBMED: | 37395811 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding author is MSK author Bridgette Thom -- Source: Scopus |
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