Kelsey L Corrigan1, Shuangshuang Fu2, Ying-Shiuan Chen1, Kelsey Kaiser1, Michael Roth3, Susan K Peterson4, Ya-Chen T Shih2, Reshma Jagsi5,6, Sharon H Giordano2,7, Robert J Volk2, K Robin Yabroff8, Mathew P Banegas9, Chiara Acquati10,11, Rena M Conti12, Hilary Y Ma13, Kimberly Ku1, Y Nancy You14, Grace L Smith2,15. 1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 2. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas. 3. Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas. 4. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan. 6. Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan. 7. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 8. American Cancer Society, Atlanta, Georgia. 9. Department of Radiation Medicine and Applied Sciences, University of California, San Diego, San Diego, California. 10. Graduate College of Social Work, University of Houston, Houston, Texas. 11. Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas. 12. Department of Markets, Public Policy, and Law, Boston University School of Business, Boston, Massachusetts. 13. Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 14. Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas. 15. Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND: Young adults and other working-age adults with cancer are at risk for cancer-related financial toxicity (FT), including material hardships, depletion of coping resources, and psychological burden. This study compares FT domains in young adults (18-39 years old) (YAs), other working-age adults (40-64 years old), and older adults (≥65 years old) receiving cancer care. METHODS: A total of 311 adults were surveyed using the multi-domain Economic Strain and Resilience in Cancer instrument measuring FT (0-10 score indicating least to greatest FT; score ≥5 severe FT). Participants were receiving ambulatory care from March-September 2019. Associations of age with overall FT and material hardship, coping resource depletion, and psychological burden FT domains were tested using Kruskal-Wallis and χ2 tests and multivariable generalized linear models with gamma distribution. RESULTS: YAs (median age, 31.5 years) comprised 9.6% of the sample; other working-age adults comprised 56.9%. Overall, material, coping, and psychological FT scores were worse in younger age adults versus older adults (P < .001 in all multivariable models). Compared with older adults, younger age adults demonstrated worse material hardship (median scores, 3.70 vs 4.80 vs 1.30 for YAs, other working-age, and older adults, respectively; P < .001), coping resource depletion (4.50 vs 3.40 vs 0.80; P < .001), and psychological burden (6.50 vs 7.00 vs 1.00; P < .001). Fifty percent of YAs had severe overall FT versus 40.7% of other working-age adults and 9.6% of older adults (P < .001). CONCLUSIONS: Younger age adults with cancer bore disproportionate FT. Interventions to address unmet needs are critical components for addressing FT in this population.
BACKGROUND: Young adults and other working-age adults with cancer are at risk for cancer-related financial toxicity (FT), including material hardships, depletion of coping resources, and psychological burden. This study compares FT domains in young adults (18-39 years old) (YAs), other working-age adults (40-64 years old), and older adults (≥65 years old) receiving cancer care. METHODS: A total of 311 adults were surveyed using the multi-domain Economic Strain and Resilience in Cancer instrument measuring FT (0-10 score indicating least to greatest FT; score ≥5 severe FT). Participants were receiving ambulatory care from March-September 2019. Associations of age with overall FT and material hardship, coping resource depletion, and psychological burden FT domains were tested using Kruskal-Wallis and χ2 tests and multivariable generalized linear models with gamma distribution. RESULTS: YAs (median age, 31.5 years) comprised 9.6% of the sample; other working-age adults comprised 56.9%. Overall, material, coping, and psychological FT scores were worse in younger age adults versus older adults (P < .001 in all multivariable models). Compared with older adults, younger age adults demonstrated worse material hardship (median scores, 3.70 vs 4.80 vs 1.30 for YAs, other working-age, and older adults, respectively; P < .001), coping resource depletion (4.50 vs 3.40 vs 0.80; P < .001), and psychological burden (6.50 vs 7.00 vs 1.00; P < .001). Fifty percent of YAs had severe overall FT versus 40.7% of other working-age adults and 9.6% of older adults (P < .001). CONCLUSIONS: Younger age adults with cancer bore disproportionate FT. Interventions to address unmet needs are critical components for addressing FT in this population.
Authors: Samantha T Pannier; Echo L Warner; Brynn Fowler; Douglas Fair; Sara K Salmon; Anne C Kirchhoff Journal: J Cancer Educ Date: 2019-04 Impact factor: 2.037
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Authors: K Robin Yabroff; Emily C Dowling; Gery P Guy; Matthew P Banegas; Amy Davidoff; Xuesong Han; Katherine S Virgo; Timothy S McNeel; Neetu Chawla; Danielle Blanch-Hartigan; Erin E Kent; Chunyu Li; Juan L Rodriguez; Janet S de Moor; Zhiyuan Zheng; Ahmedin Jemal; Donatus U Ekwueme Journal: J Clin Oncol Date: 2015-12-07 Impact factor: 44.544
Authors: Grace L Smith; Maria A Lopez-Olivo; Pragati G Advani; Matthew S Ning; Yimin Geng; Sharon H Giordano; Robert J Volk Journal: J Natl Compr Canc Netw Date: 2019-10-01 Impact factor: 11.908
Authors: Ryan D Nipp; Hang Lee; Emily Gorton; Morgan Lichtenstein; Salome Kuchukhidze; Elyse Park; Bruce A Chabner; Beverly Moy Journal: Oncologist Date: 2019-04-15