Department of Health Policy, Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education (MAHE), Manipal, India.
Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
JCO Glob Oncol. 2024 Jul;10:e2300397. doi: 10.1200/GO.23.00397.
The rising cost of cancer treatment causes out-of-pocket spending among patients or caregivers in lower-middle-income countries, resulting in acute misery and insolvency. This study aimed to assess the financial toxicity associated with cancer treatment and the coping strategies for cancer treatment adopted among the caregivers of patients with cancer in a tertiary cancer care center.
This prospective cross-sectional study was conducted among the primary caregivers of patients with cancer undergoing curative treatment from March to June 2023. The estimated sample size was 403 caregivers. The financial toxicity was assessed using a modified Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy tool, and coping strategies were explored using a validated questionnaire of 20 questions. Univariate and multivariate analyses investigated the associations and factors influencing financial toxicity.
The caregivers recruited in the study were 403; 83.8% were younger than 50 years, and 66.5% were male. The common cancer types included were breast cancer (27.3%), GI cancer (17.9%), head and neck cancer (12.4%), and gynecological cancer (11.6%). The mean financial toxicity score was 22.32 (standard deviation, 9.55), with 64% experiencing moderate to severe financial toxicity. The most common coping strategies used were spending a portion or all of the savings, borrowing money from others, restructuring their spending habits, seeking financial assistance from the cancer center, and resorting to gold loans.
Screening patients and their primary caregivers using a modified COST tool can help identify families experiencing severe financial toxicity and provide necessary intervention.
癌症治疗费用的不断上涨导致中低收入国家的患者或照护者产生自付费用，导致他们陷入极度痛苦和破产的境地。本研究旨在评估癌症治疗相关的财务毒性，并评估在一家三级癌症治疗中心的癌症患者照护者中采用的癌症治疗应对策略。
这是一项于 2023 年 3 月至 6 月期间在接受根治性治疗的癌症患者的主要照护者中进行的前瞻性横断面研究。估计的样本量为 403 名照护者。使用改良的全面财务毒性-慢性疾病治疗功能评估量表来评估财务毒性，使用经过验证的包含 20 个问题的问卷来探索应对策略。使用单变量和多变量分析来调查相关性和影响财务毒性的因素。
研究中招募的照护者为 403 名；83.8%的年龄小于 50 岁，66.5%为男性。常见的癌症类型包括乳腺癌（27.3%）、胃肠道癌症（17.9%）、头颈部癌症（12.4%）和妇科癌症（11.6%）。平均财务毒性评分（标准偏差为 9.55）为 22.32，64%的人经历了中度至重度的财务毒性。最常用的应对策略包括花费部分或全部储蓄、向他人借款、调整支出习惯、向癌症中心寻求经济援助和求助于黄金贷款。
使用改良的 COST 工具对患者及其主要照护者进行筛查可以帮助识别出正在经历严重财务毒性的家庭，并提供必要的干预。
