Financial Toxicity Investigation And Influencing Factors Analysis Among Patients With Non-metastatic Breast Cancer

Objective:To assess the financial toxicity(FT)among non-metastatic breast cancer patients' by the translated Chinese version of the of the Financial Toxicity Comprehensive Rating Scale(COST-FACIT:COmprehensive Score for financial Toxicity-Functional Assessment of Chronic Illness Therapy)and to investigate patients and cancer characteristic that associated with it in patients.Methods:This was a cross-sectional study among 188 patients with stage 0-III women breast cancer admitted in Bethune hospital in Taiyuan,Shanxi province during January-May 2019.The household income,FT(COST score),coping strategies and financial concern were self-reported in the form of questionnaire;Patients' sociodemographic factors,clinical examination,and cancer treatment were collected from hospital record.Factors associated with FT was identified using linear regression analysis.Results:Of the 188 breast cancer women surveyed,166(88.2%)completed the questionnaire.The median age was 52 years(range 27-77 years),the COST score ranged 0-40 with a mean of 21.2(median 22.5,standard deviation 8.1),and with lower COST score indicating a higher FT.On multivariate linear regression analysis,older age(? coefficient: 0.20,95% CI: 0.11-0.29,p<0.001),higher household income(? coefficient: 3000-5000 Yuan: 7.88,95% CI: 4.74-11.01,p<0.001;? 5000 Yuan: 12.81,95% CI: 9.54-16.08,p<0.001)were positively associated with COST scores.Advanced cancer stage was the strongest predictor of FT among the cancer characteristics(? coefficient:-4.52,95% CI:-7.13--1.92,p=0.001).To cope with the FT,131(78.8%)patients decreased non-medical expenses,and 56(33.7%)reduced or quit treatment.Conclusion:FT was significantly associated with patient's age,income,and cancer stage.Women having financial concerns after diagnosis were more likely to reduce their non-medical expenses and even quit treatments.Clinicians should take into account the FT levels in all patients and work out appropriate treatment strategies for optimal clinical outcome.