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Financial hardship in breast cancer survivors: a prospective analysis of change in financial concerns over time

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Abstract

Purpose

Medical financial hardship, encompassing material, behavioral, and psychologic domains, has been shown to impair quality of life during and after cancer therapy. We sought to evaluate the change in financial concerns in breast cancer survivors over time and identify those at risk of worsening financial concerns.

Methods

In Mayo Clinic Breast Disease Registry (MCBDR), a prospective cohort of consenting patients seen at Mayo Clinic Rochester within 1 year of their initial breast cancer diagnosis, consenting participants were asked to complete baseline and annual follow-up surveys that included an item on which respondents were asked to report their financial concerns on a linear analogue scale from 0 (“none”) to 10 (“constant concerns”). We compared patient-reported financial concern at baseline to that on each patient’s most recent survey, with worsening concerns defined as a 1+-point increase. Logistic regression analysis evaluated for possible predictors of worsening financial concerns.

Results

One-thousand nine-hundred fifty-seven participants responded to financial concern questions on the baseline and at least one follow-up survey between 2015 and 2020. Three-hundred fifty-seven (18.2%) reported worsening financial concerns. Only baseline financial situation of “enough to pay the bills, but little spare money to buy extra or special things,” was associated with a greater likelihood of worsening financial concerns.

Conclusions

More than one in seven breast cancer survivors develop worsening financial concerns within 5 years of diagnosis, and those with less financial security at baseline appear to be most vulnerable.

Implication for cancer survivors

Financial concerns may worsen over time for breast cancer survivors, and therefore, oncology providers must continue to assess the financial well-being of survivors over time.

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Abbreviations

MCBDR:

Mayo Clinic Breast Disease Registry

FH:

Financial hardship

ER:

Estrogen receptor

PR:

Progesterone receptor

Her2:

Human epidermal growth factor receptor 2-neu

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Funding

This work was supported by Breast Cancer Research Foundation (CLL), NR015259 (KJR).

Author information

Authors and Affiliations

  1. Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Michael H. Storandt & Daniela Stan

  2. Department of Hematology, Mayo Clinic, Rochester, MN, USA

    Urshila Durani

  3. Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA

    Nicole Larson & Janet E. Olson

  4. Department of Oncology, Mayo Clinic, Rochester, MN, USA

    Charles Loprinzi & Kathryn J. Ruddy

  5. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

    Fergus Couch

  6. Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ, USA

    Nandita Khera

Authors
  1. Michael H. Storandt
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  2. Urshila Durani
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Contributions

Michael Storandt contributed to statistical analysis and writing the original draft of the manuscript. Urshila Durani and Nandita Khera contributed to statistical analysis and manuscript revision. Daniela Stan, Charles Loprinzi, Fergus Couch, and Janet Olson contributed to manuscript revision. Nicole Larson contributed to data acquisition. Kathryn Ruddy contributed to project conceptualization, data analysis, and manuscript revision. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Michael H. Storandt.

Ethics declarations

Ethics approval

This research was approved by the Mayo Clinic Institutional Review Board.

Consent to participate

Consent was obtained from all who participated in the Mayo Clinic Breast Disease Registry at time of registry enrollment.

Consent to publish

N/A.

Conflict of interest

Michael H. Storandt, Urshila Durani, Daniela Stan, Nicole Larson, Fergus Cough, Janet E. Olson, and Kathryn J. Ruddy report no disclosures. Charles Loprinzi reports personal fees from PledPharma, personal fees from Disarm Therapeutics, personal fees from Asahi Kasei, personal fees from Metys Pharmaceuticals, personal fees from OnQuality, personal fees from Mitsubishi Tanabe, personal fees from NKMax, personal fees from Novartis, personal fees from HengRui, personal fees from Nuro Bio, personal fees from Osmol Therapeutics, Inc., personal fees from Grunenthal, and personal fees from Genentech outside the submitted work. Nandita Khera reports consulting fees from Incyte for chronic GVHD study.

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Storandt, M.H., Durani, U., Stan, D. et al. Financial hardship in breast cancer survivors: a prospective analysis of change in financial concerns over time. Support Care Cancer 31, 62 (2023). https://doi.org/10.1007/s00520-022-07493-6

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