Understanding financial toxicity in head and neck cancer survivors

• Published in: Oral oncology 2019-08, Vol.95, p.187-193
• Main Authors: Mady, Leila J., Lyu, Lingyun, Owoc, Maryanna S., Peddada, Shyamal D., Thomas, Teresa H., Sabik, Lindsay M., Johnson, Jonas T., Nilsen, Marci L.
• Format: Article
• Language: English
• Subjects: Cost sharing; Head and neck cancer; Health expenditures; Health services; Health-related quality of life; Multidisciplinary research; Out-of-pocket expenses; Patient reported outcomes; Survivorship; Treatment costs
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2019.06.023

•A considerable proportion of insured head and neck cancer patients demonstrate FT.•Financial toxicity (FT) differs by marital status, education level, and primary site.•Patients with larynx/hypopharynx primary tumors demonstrated the worst FT.•Most survivors use savings and/or loans to cope with out-of-pocket expenses.•This study illuminates that site-specific factors may contribute to increased risk. (1) Describe financial toxicity (FT) in head and neck cancer (HNC) survivors and assess its association with personal/health characteristics and health-related quality of life (HRQOL); (2) examine financial coping mechanisms (savings/loans); (3) assess relationship between COmprehensive Score for financial Toxicity (COST) and Financial Distress Questionnaire (FDQ). Cross-sectional survey from January – April 2018 of insured patients at a tertiary multidisciplinary HNC survivorship clinic who completed primary treatment for squamous cell carcinoma of the oral cavity, oropharynx, or larynx/hypopharynx. Of 104 survivors, 30 (40.5%) demonstrated high FT. Patients with worse FT were more likely (1) not married (COST, 25.33 ± 1.87 vs. 30.61 ± 1.34, p = 0.008); (2) of lower education levels (COST, 26.12 ± 1.47 vs. 34.14 ± 1.47, p