Unmet need for clinician engagement about financial toxicity after diagnosis of breast cancer

Details

• Alternative Title:
  Cancer
• Personal Author:
  Jagsi, Reshma ; Ward, Kevin C. ; Abrahamse, Paul ; Wallner, Lauren P. ; Kurian, Allison W. ; Hamilton, Ann S. ; Katz, Steven J. ; Hawley, Sarah T.
• Description:
  Background:
  
  Little is known about whether growing awareness of the financial toxicity of cancer diagnosis and treatment has increased clinician engagement or changed current patients’ needs.
  
  Methods:
  
  We surveyed patients with early-stage breast cancer, identified through population-based sampling from two SEER regions, and their physicians. We describe responses from 73% of surgeons (n=370), 61% of medical oncologists (n=306), 67% of radiation oncologists (n=169), and 68% of patients (n=2502).
  
  Results:
  
  Half (50.9%) of responding medical oncologists reported that someone in their practice often or always discusses financial burden with patients, as did 15.6% of surgeons and 43.2% of radiation oncologists. Patients indicated that financial toxicity remains common: 21.5% of whites and 22.5% of Asians had to cut down spending on food, as did 45.2% of blacks and 35.8% of Latinas. Many patients desired to talk to providers about the financial impact of cancer: 15.2% of whites, 31.1% of blacks, 30.3% of Latinas, and 25.4% of Asians. Unmet patient needs for engagement with doctors about financial concerns were common. Of 945 women who worried about finances, 679 (72.8%) indicated that doctors and their staff did not help. Of 523 women who desired to talk to providers about the impact of breast cancer on employment or finances, 283 (55.4%) reported no relevant discussion.
  
  Conclusion:
  
  Many patients report inadequate clinician engagement in management of financial toxicity, even though many providers believe that they make services available. Clinician assessment and communication regarding financial toxicity must improve; cure at the cost of financial ruin is unacceptable.
  
  
• Subjects:
  Article Breast Cancer Cost Finances Financial Toxicity Patient-provider Communication
• Source:
  Cancer. 124(18):3668-3676
• Pubmed ID:
  30033631
• Pubmed Central ID:
  PMC6553459
• Document Type:
  Journal Article
• Funding:
  HHSN26100006/Cancer incidence data collection in Georgia/International ; HHSN261201000140C/CA/NCI NIH HHS/United States ; P30CA46592/University of Michigan Cancer Center Biostatistics, Analytics and Bioinformatics shared resource/International ; HHSN26100006/CA/NCI NIH HHS/United States ; HHSN261201000035C/CA/NCI NIH HHS/United States ; P30 CA046592/CA/NCI NIH HHS/United States ; P01 CA163233/CA/NCI NIH HHS/United States ; U58 DP003875/DP/NCCDPHP CDC HHS/United States ; 5NU58DP003875-04-00/NCI and cooperative/International ; California Health and Safety/International ; HHSN261201300015C/RC/CCR NIH HHS/United States ; HHSN261201000140C/CA/NCI NIH HHS/United States ; Centers for Disease Control and Prevention's (CDC)/International ; HHSN261201000035C/CA/NCI NIH HHS/United States ; HHSN261201300015I/CA/NCI NIH HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; U58 DP003862/DP/NCCDPHP CDC HHS/United States ; Public Health Institute/International ; HHSN261201000034C/CA/NCI NIH HHS/United States ; P01CA163233/University of Michigan from the National Cancer Institute (NCI)/International ; 5NU58DP003862-04/DP003862/National Program of Cancer Registries under cooperative/International ; HHSN261201300015I/Cancer incidence data collection in Georgia/International
• Volume:
  124
• Issue:
  18
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:25abcbd7912aa93796d445d0b324bb0a672f29eef68bd3596ad2cd63db97f757
• Download URL:
  https://stacks.cdc.gov/view/cdc/78919/cdc_78919_DS1.pdf
• File Type:
  [PDF - 432.69 KB ]