Jun Zhou, Qiaoling Chen, Qianqian Li, Hua Jiang, Yu Lei, Xue Yang, Lemei Liu, Fanmin Li
Department of General Practice, The People's Hospital of Leshan, Leshan, China.
Department of Operating Room, The People's Hospital of Jiajiang, Leshan, China.
Front Public Health. 2025 May 15;13:1391744. doi: 10.3389/fpubh.2025.1391744. eCollection 2025.
Using the Comprehensive Score for Financial Toxicity (COST) tool to measure financial toxicity (FT) among differentiated thyroid cancer (DTC) patients in China and investigate the association between FT and psychological distress.
We carried out a cross-sectional investigation of individuals who had survived DTC in two tertiary medical facilities. The assessment of FT was performed using the Chinese version of the COST tool. The National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) was used to measure psychological distress. A multivariate logistic regression model was constructed to identify factors related to FT, and the Pearson correlation was used to evaluate the association between COST and DT scores.
Out of the 207 patients who participated in this study, the average COST score was 16.3. Notably, the prevalence of financial toxicity was 47.8% (95% CI: 41% ~ 54.7%) of the patients. Of these, 22.7% (47/207) were mild FT, 23.7% (49/207) were moderate FT, and 1.4% (3/207) were severe FT. Four variables were found to be associated with increased FT in the logistic regression model, younger age (odd ratio [OR], 4.52; = 0.003), lower educational level [OR], 1.13; = 0.040, uninsured (odd ratio [OR], 6.53; = 0.028), had lower household income (odd ratio [OR], 6.34; = 0.037), and advanced cancer (odd ratio [OR], 2.99; = 0.034). Furthermore, the Pearson correlation revealed a mild correlation between financial toxicity and psychological distress (r = -0.53, < 0.001).
In this study, the prevalence of FT in DTC patients was 47.8%. FT was associated with younger age, lower educational level, uninsured, had lower household income, and advanced cancer. Clinicians should identify patients by predictors early and conduct psychological interventions.
使用财务毒性综合评分（COST）工具来衡量中国分化型甲状腺癌（DTC）患者的财务毒性（FT），并研究FT与心理困扰之间的关联。
我们对两家三级医疗机构中DTC存活患者进行了横断面调查。使用COST工具中文版进行FT评估。采用美国国立综合癌症网络（NCCN）苦恼温度计（DT）测量心理困扰。构建多因素逻辑回归模型以确定与FT相关的因素，并使用Pearson相关性评估COST与DT评分之间的关联。
在参与本研究的207例患者中，COST平均评分为16.3。值得注意的是，财务毒性患病率为患者的47.8%（95%CI：41% ~ 54.7%）。其中，22.7%（47/207）为轻度FT，23.7%（49/207）为中度FT，1.4%（3/207）为重度FT。在逻辑回归模型中发现四个变量与FT增加相关，年龄较小（比值比[OR]，4.52；P = 0.003）、教育水平较低[OR]，1.13；P = 0.040）、未参保（比值比[OR]，6.53；P = 0.028）、家庭收入较低（比值比[OR]，6.34；P = 0.037）以及癌症晚期（比值比[OR]，2.99；P = 0.034）。此外，Pearson相关性显示财务毒性与心理困扰之间存在轻度相关性（r = -0.53，P < 0.001）。
在本研究中，DTC患者中FT患病率为47.8%。FT与年龄较小、教育水平较低、未参保、家庭收入较低以及癌症晚期相关。临床医生应尽早通过预测因素识别患者并进行心理干预。
