Financial toxicity in gynecologic oncology: a multi-practice survey.

Autor:	Smith AJ; Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia, Pennsylvania, USA annajo.smith@pennmedicine.upenn.edu.; Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.; Penn Center for Cancer Care Innovation, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Sharma MH; University of Pennsylvania, Philadelphia, Philadelphia, USA., Powell K; Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia, Pennsylvania, USA.; Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Doherty M; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.; Penn Center for Cancer Care Innovation, University of Pennsylvania, Philadelphia, Pennsylvania, USA.; School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Hinkle SN; Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia, Pennsylvania, USA.; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Ko EM; Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia, Pennsylvania, USA.; Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.; Penn Center for Cancer Care Innovation, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jazyk:	angličtina
Zdroj:	International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2024 Jun 03; Vol. 34 (6), pp. 919-925. Date of Electronic Publication: 2024 Jun 03.
DOI:	10.1136/ijgc-2023-005054
Abstrakt:	Background: Financial toxicity is associated with worse cancer outcomes, including lower survival. Objective: To characterize the prevalence of, and patient risk factors for, financial toxicity among gynecologic oncology patients in a multi-site health system. Methods: We identified patients seen in University of Pennsylvania gynecologic oncology practices between January 2020 and February 2022 with a patient portal account. We sent a survey to all alive patients twice between March and April 2022, including the 11-item Comprehensive Score for Financial Toxicity (COST) tool. We compared differences between patients reporting high (COST score <26) and low financial toxicity (COST score ≥26) in Χ 2 and regression analyses. Results: Of 8239 patients, 6925 had a portal account, and 498 completed the survey for 7.2% response rate. 44% had a COST score <26, indicating financial toxicity. Patients with high financial toxicity were more likely to be younger (mean age 54 vs 60), have cervical cancer (10% vs 4%; p=0.008), be privately insured (71% vs 57%; p=0.003) or have Medicaid (7% vs 3%; p=0.03), or be unemployed (18% vs 3%; p=<0.001), and less likely to be white (79% vs 90%, p=0.003) than those with low financial toxicity. Patients with Medicare were less likely to experience financial toxicity than privately insured patients (RR=0.59, 95% CI 0.37 to 0.95). Conclusion: In this study of patients with gynecologic cancer or pre-cancer, 44% had financial toxicity. Financial toxicity was higher in patients who were younger, did not identify as White, and had private insurance. Targeted measures to address financial toxicity are needed to minimize disparities in patient burden of cancer treatment. Competing Interests: Competing interests: The authors have disclosed no financial relationships relevant to this article. AJS has received grant funding from GSK and an award from Eisai, Inc. unrelated to this research. (© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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