Campbell University School of Osteopathic Medicine, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Am J Surg. 2019 Sep;218(3):452-456. doi: 10.1016/j.amjsurg.2019.01.033. Epub 2019 Jan 31.
The costs of cancer care in the US continue to increase and may have serious consequences for patients. We hypothesize that even cancer patients treated with curative-intent surgery alone experience substantial financial burden.
A questionnaire was administered to adult cancer patients who were treated with curative-intent surgery. Survey items included a validated instrument for measuring financial toxicity, the COST score. Demographic variables and survey responses were examined using Chi-square and Fisher exact tests. A multivariate general linear model was performed to examine the relationship between age and COST score.
COST scores varied widely. 30% of respondents had a COST score of ≤24 (high burden). Younger participants reported more financial burden (p = 0.008). Respondents reported that financial factors influenced their decisions regarding surgery (14%) and caused them to skip recommended care (4.7%). Cancer care influenced overall financial health (38%) and contributed to medical debt (26%).
Curative-intent cancer care places a substantial portion of patients at risk for financial toxicity even when they don't require chemotherapy. Interventions should not be limited to patients receiving chemotherapy.
美国癌症治疗的费用持续增加，可能会给患者带来严重后果。我们假设，即使是接受根治性手术治疗的癌症患者也会承受巨大的经济负担。
我们向接受根治性手术治疗的成年癌症患者发放了一份问卷。调查问卷包括用于衡量财务毒性的经过验证的工具，即 COST 评分。使用卡方检验和 Fisher 确切检验来检查人口统计学变量和调查结果。采用多元线性回归模型来检验年龄与 COST 评分之间的关系。
COST 评分差异很大。30%的受访者 COST 评分≤24（负担较重）。年轻的参与者报告有更大的经济负担（p=0.008）。受访者报告说，财务因素影响了他们对手术的决定（14%），并导致他们跳过了推荐的护理（4.7%）。癌症治疗会影响整体财务健康状况（38%），并导致医疗债务（26%）。
即使癌症患者不需要化疗，根治性癌症治疗也会使相当一部分患者面临财务毒性的风险。干预措施不应仅限于接受化疗的患者。
