Kimura Go, Fujii Yasuhisa, Honda Kazunori, Osawa Takahiro, Uchitomi Yosuke, Kondo Miki, Otani Ariko, Wako Tetsuya, Kawai Daisuke, Mitsuda Yoshihide, Sakashita Naotaka, Shinohara Nobuo
Department of Urology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
Department of Urology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
Cancers (Basel). 2024 May 16;16(10):1904. doi: 10.3390/cancers16101904.
Information on the financial toxicity experienced by Japanese patients with metastatic renal cell carcinoma (mRCC) is lacking, even though Japan has its own unique public health insurance system. Thus, a web-based survey was conducted to evaluate the financial toxicity experienced by Japanese mRCC patients using the COmprehensive Score for financial Toxicity (COST) tool. This study enrolled Japanese patients who underwent, or were undergoing, systemic therapy for mRCC. The outcomes evaluated were the distribution of COST scores, the correlation between COST and quality of life (QOL) assessed by the Functional Assessment of Cancer Therapy-General (FACT-G) scale, and demographic factors associated with financial toxicity. The median (range) COST score was 19.0 (3.0-36.0). The Pearson correlation coefficient for COST and FACT-G total scores was 0.40. Univariate analysis revealed that not having private health insurance and lower household income per year were significantly associated with lower COST scores. Multivariate analyses showed that age < 65 years and not having private health insurance were significantly associated with lower COST scores. This study revealed that Japanese mRCC patients experience adverse financial impacts even under the universal health insurance coverage system available in Japan, and financial toxicity negatively affects their QOL.
尽管日本拥有独特的公共医疗保险体系，但关于日本转移性肾细胞癌（mRCC）患者所经历的经济毒性的信息却很匮乏。因此，我们开展了一项基于网络的调查，以使用经济毒性综合评分（COST）工具评估日本mRCC患者所经历的经济毒性。本研究纳入了正在接受或已经接受mRCC全身治疗的日本患者。评估的结果包括COST评分的分布、COST与通过癌症治疗功能评估通用量表（FACT-G）评估的生活质量（QOL）之间的相关性，以及与经济毒性相关的人口统计学因素。COST评分的中位数（范围）为19.0（3.0 - 36.0）。COST与FACT-G总分的Pearson相关系数为0.40。单因素分析显示，没有私人医疗保险以及每年家庭收入较低与较低的COST评分显著相关。多因素分析表明，年龄<65岁以及没有私人医疗保险与较低的COST评分显著相关。本研究表明，即使在日本现有的全民医疗保险覆盖体系下，日本mRCC患者仍会经历不利的经济影响，且经济毒性会对他们的生活质量产生负面影响。
