3727 - Predictors of Financial Burden in Breast and Prostate Cancer in a Large Single Institutional Cross-Sectional Cohort Study
Presenter(s)
E. A. Sutton1, M. M. Voss2, O. T. Oladeru3, N. Y. Yu4, B. J. Stish1, J. M. Wilson1, R. Phillips1, A. W. Rajkumar1, M. Elbanna1, D. Shumway1, K. S. Corbin1, H. J. Gunn5, and M. R. Waddle1; 1Department of Radiation Oncology, Mayo Clinic, Rochester, MN, 2Department of Quantitative Health Sciences, Mayo Clinic, Phoenix, AZ, 3Department of Radiation Oncology, Mayo Clinic Jacksonville, Jacksonville, FL, 4Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, 5Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
Purpose/Objective(s): Cancer treatments impact financial well-being. However, the associations of specific factors including radiation therapy (RT), systemic treatments, and toxicities with financial endpoints are currently not well characterized. We aim to assess the impact of various factors on financial burden (FB) for patients treated for breast and prostate cancer.
Materials/Methods: A cross-sectional cohort study was distributed to 24,834 patients who received curative-intent RT for cancer at a single institution across 4 states between 2013-2022. The 23-item survey utilized modified COST-FACT questions to assess both past and current FB via a numeric composite score. Patients who received RT for breast or prostate cancer were selected for analysis. We utilized univariate ANOVA to assess patient, disease, and treatment factors as predictors of FB as measured by the modified COST-FACIT.
Results: Of 2376 responses, 609 (25.7%) had breast cancer and 667 (28.1%) prostate cancer, with median ages of 58.4 and 69.9, 95.4% and 96.1% white race, and 74.7% and 87.1% married, respectively. A total of 32.6% of breast and 16.0% of prostate cancer patients reported facing financial problems as a direct result of illness and treatment (23.9% total). In both breast and prostate cancer patients, current and past FB as measured by COST-FACIT and answer to the prompt “I have faced financial problems as a direct result of my illness or treatment” were better with Medicare insurance and worse with decreasing age and grade 2+ and 3+ PRO toxicities. Peri-treatment hospitalizations were predictors of past financial burden but not current. There was no difference in past or present FB based on RUCA, distance from treatment facility, treatment modality, or use of hormonal therapy. Among prostate cancer patients who received hormonal therapy, long-term ADT (12+ months) was associated with greater financial burden than short-term (4-6 months). In patients with breast cancer, current and past FB were worse in non-white and unmarried patients, longer RT fractionation, treatment of regional nodes, grade 2+ toxicity, and immuno- and chemotherapy use. These factors were not predictors of FB for prostate cancer patients, nor were Gleason score or PSA.
Conclusion: Patients with breast cancer experienced more FB than patients with prostate cancer, with several associations identified. Most risk factors for FB are unmodifiable; however improved toxicity management and utilization of shorter fractionation (in breast cancer) may help alleviate burden.