Wu Yan, Liu Xianchen, Maculaitis Martine C, Li Benjamin, Berk Alexandra, Massa Angelina, Weiss Marisa C, McRoy Lynn
Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ 07103, USA.
Pfizer Inc., New York, NY 10001, USA.
Cancers (Basel). 2023 Dec 21;16(1):62. doi: 10.3390/cancers16010062.
This study reported the prevalence of financial distress (financial toxicity (FT)) and COVID-19-related economic stress in patients with breast cancer (BC). Patients with BC were recruited from the Ciitizen platform, Breastcancer.org, and patient advocacy groups between 30 March and 6 July 2021. FT was assessed with the COmprehensive Score for financial Toxicity (COST) instrument. COVID-19-related economic stress was assessed with the COVID-19 Stress Scale. Among the 669 patients, the mean age was 51.6 years; 9.4% reported a COVID-19 diagnosis. The prevalence rates of mild and moderate/severe FT were 36.8% and 22.4%, respectively. FT was more prevalent in patients with metastatic versus early BC ( < 0.001). The factors associated with FT included income ≤ USD 49,999 (adjusted odds ratio (adj OR) 6.271, < 0.0001) and USD 50,000-USD 149,999 (adj OR 2.722, < 0.0001); aged <50 years (adj OR 3.061, = 0.0012) and 50-64 years (adj OR 3.444, = 0.0002); living alone (adj OR 1.603, = 0.0476); and greater depression severity (adj OR 1.155, < 0.0001). Black patients (adj OR 2.165, = 0.0133), patients with income ≤ USD 49,999 (adj OR 1.921, = 0.0432), or greater depression severity (adj OR 1.090, < 0.0001) were more likely to experience COVID-19-related economic stress. FT was common in patients with BC, particularly metastatic disease, during COVID-19. Multiple factors, especially lower income and greater depression severity were associated with financial difficulties during COVID-19.
本研究报告了乳腺癌（BC）患者中财务困境（财务毒性（FT））和与COVID-19相关的经济压力的患病率。2021年3月30日至7月6日期间，从Ciitizen平台、Breastcancer.org和患者倡导组织招募了BC患者。使用财务毒性综合评分（COST）工具评估FT。使用COVID-19压力量表评估与COVID-19相关的经济压力。在669名患者中，平均年龄为51.6岁；9.4%的患者报告确诊感染COVID-19。轻度和中度/重度FT的患病率分别为36.8%和22.4%。与早期BC相比，FT在转移性BC患者中更为普遍（<0.001）。与FT相关的因素包括收入≤49,999美元（调整后的优势比（adj OR）6.271，<0.0001）和50,000美元至149,999美元（adj OR 2.722，<0.0001）；年龄<50岁（adj OR 3.061，=0.0012）和50-64岁（adj OR 3.444，=0.0002）；独居（adj OR 1.603，=0.0476）；以及抑郁严重程度更高（adj OR 1.155，<0.0001）。黑人患者（adj OR 2.165，=0.0133）、收入≤49,999美元的患者（adj OR 1.921，=0.0432）或抑郁严重程度更高的患者（adj OR 1.09o，<0.0001）更有可能经历与COVID-19相关的经济压力。在COVID-19期间，FT在BC患者中很常见，尤其是转移性疾病患者。多种因素，特别是较低的收入和较高的抑郁严重程度与COVID-19期间的财务困难有关。
