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Financial toxicity and its associated patient and cancer factors among women with breast cancer: a single-center analysis of low-middle income region in China

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

To assess the financial toxicity (FT) and to investigate patients and cancer characteristic that associated with it in patients admitted in a tertiary hospital in central China.

Methods

This was a cross-sectional study of 166 patients from 188 with stage 0-III women breast cancer admitted in Bethune hospital in Taiyuan, Shanxi province during January–May 2019. FT was self-reported using of financial Toxicity Comprehensive Rating Scale (COST-FACIT). Patients’ sociodemographic factors, clinical examination, and cancer treatment were collected from questionnaire and hospital record. The financial concern and coping strategy was self-reported. Factors associated with FT were identified using linear regression analysis.

Results

Of the 166 completed the survey, the COST score ranged 0–40 with a mean of 21.2 (median 22.5, standard deviation 8.1). On multivariate linear regression analysis, older age (β coefficient: 0.20, 95% CI 0.11–0.29, p < 0.001), higher household income (β coefficient: 3000–5000 Yuan: 7.88, 95% CI 4.74–11.01, p < 0.001; ≥ 5000 Yuan: 12.81, 95% CI 9.54–16.08, p < 0.001) were positively associated with COST scores. Advanced cancer stage was the strongest predictor of FT among the cancer characteristics (β coefficient: − 4.52, 95% CI − 7.13–1.92, p = 0.001). To cope with the FT, 131 (78.8%) patients decreased non-medical expenses, and 56 (33.7%) reduced or quitted treatment.

Conclusions

FT was significantly associated with patient’s age, income, and cancer stage. Women having financial concerns after diagnosis were more likely to reduce their non-medical expenses and even quit treatments. Clinicians should take into account the FT levels in all patients and work out appropriate treatment strategies for optimal clinical outcome.

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Funding

This project was sponsored by “136 Medical Project” by Shanxi provincial government. We thank all patients, staff from the Breast Surgery Division in Shanxi Bethune Hospital for data collection. We thank Dr. Hao Li for her statistical assistance.

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Authors and Affiliations

  1. Department of Breast Surgery, Shanxi Academy of Medical Sciences, The Affiliated Shanxi Bethune Hospital of Shanxi Medical University, Taiyuan, 030032, Shanxi, China

    Jingfeng Jing, Ran Feng, Xiaojun Zhang, Ming Li & Jinnan Gao

  2. Cancer Research Institute, University of South Australia, Adelaide, 5000, Australia

    Ming Li

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  1. Jingfeng Jing
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Contributions

Conceptualization: JG, JJ, ML, XZ, RF. Project administration: JG. Methodology: JG, JJ, ML, XZ. Data Curation: JJ, RF. Formal analysis: ML. Manuscript preparation: JG, JJ, ML, RF. Final approval of manuscript: all authors.

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Correspondence to Jinnan Gao.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The investigations conducted in this study comply with the current laws of the country in which they were performed.

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Jing, J., Feng, R., Zhang, X. et al. Financial toxicity and its associated patient and cancer factors among women with breast cancer: a single-center analysis of low-middle income region in China. Breast Cancer Res Treat 181, 435–443 (2020). https://doi.org/10.1007/s10549-020-05632-3

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