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Prevalence of and Factors Associated with Financial Toxicity After Pancreatectomy and Gastrectomy

  • Global Health Services Research
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Financial toxicity (FT) refers to the adverse impact of cancer treatment costs on patients’ experiences, potentially leading to poor adherence to treatment and outcomes. However, the prevalence of FT among patients undergoing major upper gastrointestinal cancer operations, as well as factors associated with FT, remain unclear.

Methods

We conducted a cross-sectional study by sending the Comprehensive Score for financial Toxicity (COST) survey and Surgery-Q (a survey specifically developed for this study) to patients who underwent gastrectomy or pancreatectomy for malignant disease at our institution in 2019–2021.

Results

We sent the surveys to 627 patients and received responses from 101 (16%) patients. The FT prevalence (COST score <26) was 48 (48%). Patients likely to experience FT were younger than 50 years of age, of non-White race, earned an annual income <$75,000, and had credit scores <740 (all p < 0.05). Additionally, longer hospital stay (p = 0.041), extended time off work for surgery (p = 0.011), and extended time off work for caregivers (p = 0.005) were associated with FT. Procedure type was not associated with FT; however, patients who underwent minimally invasive surgery (MIS) had a lower FT probability (p = 0.042). In a multivariable analysis, age <50 years (p = 0.031) and credit score <740 (p < 0.001) were associated with high FT risk, while MIS was associated with low FT risk (p = 0.024).

Conclusions

Patients with upper gastrointestinal cancer have a major risk of FT. In addition to predicting the FT risk before surgery, facilitating quicker functional recovery with the appropriate use of MIS is considered important to reducing the FT risk.

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Acknowledgments

The authors thank Ann Sutton, Scientific Editor in the Research Medical Library at The University of Texas MD Anderson Cancer Center, for editing this article.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Yuki Hirata MD, PhD, Connie To APRN, Heather Lyu MD, MBI, Hop S. Tran Cao MD, Brian D. Badgwell MD, MS, Matthew H. G. Katz MD & Naruhiko Ikoma MD, MS

  2. Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Grace L. Smith MD, PhD, MPH

  3. Division of Pediatric Nephrology and Hypertension, The University of Texas Health Science Center-Houston, Houston, TX, USA

    Joyce P. Samuel MD, MS

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  1. Yuki Hirata MD, PhD
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  2. Connie To APRN
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Correspondence to Naruhiko Ikoma MD, MS.

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Disclosure

Yuki Hirata, Connie To, Heather Lyu, Grace L. Smith, Joyce P. Samuel, Hop S. Tran Cao, Brian D. Badgwell, Matthew H. G. Katz, and Naruhiko Ikoma have no relevant financial or non-financial interests to disclose.

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Hirata, Y., To, C., Lyu, H. et al. Prevalence of and Factors Associated with Financial Toxicity After Pancreatectomy and Gastrectomy. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15236-6

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