Financial toxicity and its effect on screening for prostate and colon cancer.

Authors

null

Michael Joseph Herriges Jr.

The University of Toledo College of Medicine and Life Sciences, Department of Pediatrics, Toledo, OH

Michael Joseph Herriges Jr., Rachel Shenhav-Goldberg , Juliet Irene Peck , Oleg Shapiro , Joseph M Jacob , Alina Basnet , Gennady Bratslavsky , Hanan Goldberg

Organizations

The University of Toledo College of Medicine and Life Sciences, Department of Pediatrics, Toledo, OH, The Bob Shapell School of Social Work, Tel-Aviv University, TEL Aviv-Jaffa, Israel, Shenandoah University, Performing Arts Medicine Department, Winchester, VA, SUNY Upstate Medical University, Department of Urology, Syracuse, NY, SUNY Upstate Medical University, Department of Hematology/Oncology, Syracuse, NY

Research Funding

No funding received

Background: The term ‘financial toxicity’ or ‘hardship’ is used to describe the financial problems patients experience due to high out-of-pocket costs for their healthcare. Financial toxicity in the context of cancer treatment is an area of recent study due to the significant costs associated with these treatments, but little is known about the effect of financial toxicity on cancer prevention. We examined the effects of financial toxicity on the utilization of screening tests for prevalent cancers, including prostate and colon cancer, using a US nationally representative survey-based data source. We hypothesized that patients with more financial hardship would show an association with decreased prevalence of prostate and colon cancer screening. Methods: This cross-sectional survey-based US study included men and women aged 18+ from the National Health Interview Survey (NHIS) database from January – December 2018. A financial hardship score between 0 and 1 was formulated by summarizing the responses from ten financial toxicity questions including if in the past 12 months one was unable to afford prescription medication or healthcare; or if one had to skip or take less medicine to save money. A higher score was associated with a worse financial hardship score. The primary outcomes of the study were self-reported occurrence of PSA blood testing for prostate cancer screening, and occurrence of colonoscopy for colon cancer screening. Results: As shown in table, a higher financial hardship score was associated with a decreased odds ratio for having a PSA test of 0.916 (95% CI 0.867-0.967, p=0.002) and colonoscopy of 0.969 (95% CI 0.941-0.998, p=0.039). Conclusions: Worse financial hardship is associated with a decreased probability of having PSA or colonoscopy screening tests. Awareness of this specific toxicity needs to be raised, examining the association of financial toxicity and screening of prostate, colon, and other additional cancers.

Logistic multivariable regression models assessing associations with having PSA test and colonoscopy.

Had PSA TestHad Colonoscopy
OR (95% CI)P valueOR (95% CI)P value
Age (Continuous)1.031 (1.020-1.042)<0.0011.032 (1.027-1.038)<0.001
Gender (Male vs Female)N/AN/A1.124 (1.028-1.229)0.010
Working Status (Working vs Not Working)1.182 (0.994-1.405)0.0580.939 (0.848-1.040)0.230
Marital Status (Spouse vs No Spouse)1.671 (1.435-1.946)<0.0011.414 (1.291-1.547)<0.001
Financial Hardship Score (Continuous)0.916 (0.867-0.967)0.0020.969 (0.941-0.998)0.039

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Abstract Details

Meeting

2022 ASCO Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer - Advanced,Prostate Cancer - Localized

Sub Track

Cancer Disparities

Citation

J Clin Oncol 40, 2022 (suppl 6; abstr 21)

DOI

10.1200/JCO.2022.40.6_suppl.021

Abstract #

21

Poster Bd #

Online Only

Abstract Disclosures

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