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Association between financial toxicity and health-related quality of life of patients with gynecologic cancer

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International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Objectives

Patients often struggle with their financial situation during cancer treatment due to treatment-related costs or loss of income. This resulting negative effect is called financial toxicity, which is a known as a side effect of cancer care. This study aimed to evaluate the association between financial toxicity and health-related quality of life among patients with gynecologic cancer using validated questionnaires.

Methods

In this multicenter study, patients with gynecologic cancer receiving anti-cancer drug treatment for > 2 months were recruited. Patients answered the COmprehensive Score for Financial Toxicity (COST) tool, EORTC-QLQ-C30, disease-specific tools (EORTC-QLQ-OV28/CX24/EN24), and EQ-5D-5L. Spearman’s rank correlation coefficient was used to determine associations.

Results

Between April 2019 and July 2021, 109 cancer patients completed the COST questionnaire. The mean COST score was 19.82. Strong associations were observed between financial difficulty (r = − 0.616) in the EORTC-QLQ-C30 and body image (r = 0.738) in the EORTC-QLQ-CX24, while weak associations were noted between the global health status/quality of life (r = 0.207), EQ-5D-5L index score (r = 0.252), and several function and symptom scale scores with the COST score.

Conclusions

Greater financial toxicity was associated with worse health-related quality of life scores, such as financial difficulty in gynecologic cancer patients and body image in cervical cancer patients as strong associations, and weakly associated with general health-related quality of life scores and several function/symptom scales.

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Data availability

Individual participant data that underlie the results reported in this article after deidentification and study materials are available upon reasonable request.

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Acknowledgements

We thank the patients and their families as well as the investigators and site personnel involved in the study. English language editing was performed using Editage. This work was partly presented as an oral presentation at the 2022 Japanese Society of Medical Oncology Annual Meeting in Tokyo, Japan, on February 17-19, 2021.

Funding

The authors received no specific funding for this work.

Author information

Authors and Affiliations

  1. Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan

    Yusuke Kajimoto, Lida Teng & Ataru Igarashi

  2. Oncology Science Unit, MSD K.K., 1-13-12 Kudan-Kita, Chiyodaku, Tokyo, 102-8667, Japan

    Yusuke Kajimoto

  3. Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan

    Kazunori Honda

  4. Department of Gynecologic Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan

    Shiro Suzuki, Masahiko Mori & Hirofumi Tsubouchi

  5. Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi City, Gunma, 371-8511, Japan

    Kohshiro Nakao & Anri Azuma

  6. Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kitaoujicho, Akashi, Hyogo, 673-8558, Japan

    Takashi Shibutani

  7. Department of Gynecologic oncology, Hyogo Cancer Center, 13-70 Kitaoujicho, Akashi, Hyogo, 673-8558, Japan

    Shoji Nagao

  8. Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan

    Shoji Nagao

  9. Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Takahiro Koyanagi

  10. School of Nursing, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Izumi Kohara

  11. Nursing Department, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Shuko Tamaki & Midori Yabuki

  12. Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Keiichi Fujiwara

  13. Department of Public Health, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan

    Ataru Igarashi

Authors
  1. Yusuke Kajimoto
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  2. Kazunori Honda
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  3. Shiro Suzuki
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  4. Masahiko Mori
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  5. Hirofumi Tsubouchi
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  6. Kohshiro Nakao
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  7. Anri Azuma
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  8. Takashi Shibutani
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  9. Shoji Nagao
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  10. Takahiro Koyanagi
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  11. Izumi Kohara
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  12. Shuko Tamaki
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  13. Midori Yabuki
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  14. Lida Teng
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  15. Keiichi Fujiwara
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  16. Ataru Igarashi
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Contributions

YK contributed to conceptualization, methodology, formal analysis, resources, data curation, writing the original draft, and project administration. KH contributed to conceptualization, methodology, resources, investigation, and writing of the original draft. LT performed writing, review, and project administration. KF contributed to methodology and writing—review. AI contributed to conceptualization, methodology, formal analysis, writing—review and editing, and supervision. Other authors contributed to investigation, resources, writing, review, and editing.

Corresponding author

Correspondence to Yusuke Kajimoto.

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Conflict of interest

Yusuke Kajimoto is an employee of the MSD K.K. Ataru Igarashi received a consultant fee, grants, and other from Pfizer Japan Inc. and Terumo Corporation; a consultant fee and grants from Beckton Dickinson and Company, Milliman Inc., and Taiho Pharmaceutical Co. Ltd.; a consultant fee and others from Abbvie GK, Ayumi Pharmaceutical Inc., Chugai Pharmaceuticals Inc., Eisai Inc., GSK., Nippon Boehringer Ingelheim Inc., Novartis Pharma K.K., Novo Nordisk Japan Inc., Ono Pharmaceutical Inc., Sumitomo Dainippon Pharma Inc., and Takeda Pharmaceutical Inc.; consultant fees from Otsuka Pharmaceutical Co., Ltd. and Sanofi Japan Inc.; grants and others from Gilead Sciences K.K.; grants from Boston Scientific Japan Inc. and Intuitive Surgical GK.; others from Astellas Pharma Inc., CSL Behring Japan Inc., Fuji Film Inc. and Medilead Inc. The other authors have no conflicts of interest to declare.

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Kajimoto, Y., Honda, K., Suzuki, S. et al. Association between financial toxicity and health-related quality of life of patients with gynecologic cancer. Int J Clin Oncol 28, 454–467 (2023). https://doi.org/10.1007/s10147-023-02294-1

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  • DOI: https://doi.org/10.1007/s10147-023-02294-1

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