Klok Jente M, Duijts Saskia F A, Engelen Vivian, Masselink Roel, Dingemans Anne-Marie C, Aerts Joachim G J V, Lingsma Hester F, van Klaveren David
Department of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Public Health, Erasmus University Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands.
J Cancer Surviv. 2024 Sep 3. doi: 10.1007/s11764-024-01668-2.
Financial toxicity, the subjective distress caused by objective financial burden, significantly impacts cancer survivors. Yet, enduring effects on survivors remain unclear. Therefore, we investigated the experienced objective financial burden and subjective financial distress in long-term cancer survivors.
A cross-sectional nationwide online survey of adult cancer survivors ≥ 5y after diagnosis were analyzed. Objective financial burden was measured via extra expenses and income loss, while subjective financial distress covered psychological well-being, coping and support-seeking behavior, and financial concerns. Groups were compared (i.e., having cancer vs. former patients) by t-tests and chi-squared tests. Financial toxicity was visualized with Sankey plots and sunburst diagrams.
4,675 respondents completed the survey, of whom 2,391 (51%) were ≥ 5y after their cancer diagnosis. Among them, 75% experienced income loss and/or extra expenses after diagnosis. One-third of the previously employed respondents relied on work disability benefits. Further, 'being unable to make ends meet' increased from 2% before diagnosis to 13% ≥ 5y after diagnosis (p < .001). Additionally, 58% reported negative psychological impacts of financial toxicity, and 47% worried about their financial future.
Cancer survivors often face income loss and additional expenses, leading to ongoing financial difficulties that affect their psychological well-being. Despite this significant impact, there is a lack of guidance and support to help them manage these financial challenges. These findings highlight the need for healthcare professionals to recognize and address the financial challenges.
This study underscores the widespread financial challenges cancer survivors encounter, emphasizing the need for ongoing financial support and comprehensive assessments of their physical and psychological well-being.
经济毒性是由客观经济负担引起的主观痛苦，对癌症幸存者有显著影响。然而，对幸存者的持久影响仍不清楚。因此，我们调查了长期癌症幸存者经历的客观经济负担和主观经济痛苦。
对诊断后≥5年的成年癌症幸存者进行了一项全国性的横断面在线调查分析。客观经济负担通过额外费用和收入损失来衡量，而主观经济痛苦则涵盖心理健康、应对和寻求支持行为以及经济担忧。通过t检验和卡方检验对各组（即患癌者与既往患者）进行比较。用桑基图和旭日图直观展示经济毒性。
4675名受访者完成了调查，其中2391人（51%）在癌症诊断后≥5年。其中，75%的人在诊断后经历了收入损失和/或额外费用。三分之一以前就业的受访者依靠工伤残疾福利。此外，“无法维持收支平衡”的比例从诊断前的2%增加到诊断后≥5年的13%（p<0.001）。此外，58%的人报告了经济毒性对心理的负面影响，47%的人担心自己的经济未来。
癌症幸存者经常面临收入损失和额外费用，导致持续的经济困难，影响他们的心理健康。尽管有如此重大的影响，但缺乏帮助他们应对这些经济挑战的指导和支持。这些发现凸显了医疗保健专业人员认识和应对经济挑战的必要性。
本研究强调了癌症幸存者普遍面临的经济挑战，强调需要持续的经济支持以及对他们身心健康的全面评估。
