Work

Rural cancer financial toxicity screening

Year: 2025

Type: article

Abstract: Purpose/Objectives Cancer treatment expenses can lead to financial toxicity (FT), which reduces treatment compliance and impairs outcomes. Little is known regarding the FT among rural cancer populations, where added barriers impair accrual of survey data. To increase our understanding of FT experienced by these patients, we piloted a validated survey instrument and reported on the feasibility of administration. Materials/Methods Institutional approval was obtained to prospectively survey rural oncology patients undergoing radiation treatment. Baseline surveys were provided at simulation appointments; weekly surveys were captured during on-treatment visits. Respondents reported on demographics (including sex, race, education, income, insurance, employment) at baseline and on expenses, the COmprehensive Score for financial Toxicity (COST, range 0-44, modified such that higher score indicates worse toxicity), perception of providers' financial empathy, and the minimum financially impactful amount of money at weekly visits. Completion rates and associations between demographic characteristics and FT were assessed with Mann-Whitney U-test. Results Twenty-six participants were enrolled. Patients were elderly (mean 68.3 years old, SD 10.7), male (25 of 26), white (25 of 26). Forty-two percent were low-income (annual income less than $48,000) and 50% had high-school or less education. Most (n=19, 73%) were insured through Medicare. 85% of surveys were fully complete. The mean COST score at baseline was 14.0 (SD 11.5, range 0-38). The mean amount of money that would make a meaningful difference was $211 at baseline (IQR $87.50, $350) and rose to $329 towards the end of the survey period (week 7). Conclusions FT screening of rural radiation oncology populations with a range of education is feasible with high fidelity of data collection. Future steps will identify patterns and predictors of severe FT and develop targeted interventions based on this feasibility study.

Source: Advances in Radiation Oncology

DOI: 10.1016/j.adro.2025.101910

Authors: Yash Deshmukh, Melanie L. Rose, Renata W. Yen, Sybil T. Jones, Nirav S. Kapadia

Institutions: Dartmouth College, Dartmouth Health, Dartmouth Institute for Health Policy and Clinical Practice, Memorial Sloan Kettering Cancer Center

Language: English

Topic: Economic and Financial Impacts of Cancer

Subfield: Economics and Econometrics

Field: Economics, Econometrics and Finance

Domain: Social Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $2,500