Financial toxicity in patients with gynecologic malignancies: a cross sectional study

Authors

Burak Zeybek, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA. burak.zeybek@yale.edu.
Emily Webster, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Natalia Pogosian, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY, USA.
Joan Tymon-Rosario, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Alan Balch, Patient Advocate Foundation, Hampton, VA, USA.
Gary Altwerger, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Mitchell Clark, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Gulden Menderes, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Gloria Huang, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Masoud Azodi, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Elena S. Ratner, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Peter E. Schwartz, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Alessandro D. Santin, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Vaagn Andikyan, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.

Document Type

Article

Publication Title

Journal of gynecologic oncology

Abstract

OBJECTIVE: To evaluate financial toxicity and assess its risk factors among patients with gynecologic cancers. METHODS: This is a cross sectional study that included 2 survey tools, as well as patient demographics, disease characteristics, and treatment regimen. Financial toxicity is measured by validated Comprehensive Score for Financial Toxicity (COST) tool. Participants were also asked to complete a 55-question-survey on attitudes and perspectives surrounding cost of care. Descriptive statistics was used to report patient demographics. Spearman's rank correlation was calculated to assess the relation between financial toxicity and patient/disease related variables. Graphpad Prism Software Version 8.0 was used for analyses. RESULTS: A total of 50 patients with various gynecologic malignancies were enrolled. Median COST score was 20.5 (range, 1-33). Sixty-five percent of the patients reported being in debt due to their cancer care and 4% filed bankruptcy. Correlation analysis showed that COST score was correlated with age (r=-0.3, p=0.028), malignancy type (r=0.3, p=0.039) and income (r=0.3, p=0.047). Ovarian cancer patients had significantly less financial toxicity (median COST score=23) when compared to patients with other gynecologic malignancies (median COST score=17, p=0.043). When scores were dichotomized into low (score ≥22) and high toxicity (score <22), 58% (29/50) of the patients were noted to have high financial toxicity. Enrollment to a clinical trial did not significantly alleviate financial burden. CONCLUSION: Financial toxicity is a significant burden even among highly insured gynecologic oncology patients. Age, malignancy type and income were correlated with high financial burden.

First Page

e87

DOI

10.3802/jgo.2021.32.e87

Publication Date

11-1-2021

Recommended Citation

Zeybek, Burak; Webster, Emily; Pogosian, Natalia; Tymon-Rosario, Joan; Balch, Alan; Altwerger, Gary; Clark, Mitchell; Menderes, Gulden; Huang, Gloria; Azodi, Masoud; Ratner, Elena S.; Schwartz, Peter E.; Santin, Alessandro D.; and Andikyan, Vaagn, "Financial toxicity in patients with gynecologic malignancies: a cross sectional study" (2021). Obstetrics and Gynecology. 77.
https://scholar.bridgeporthospital.org/obgyn/77

Identifier

34431257 (pubmed); PMC8550931 (pmc); 10.3802/jgo.2021.32.e87 (doi); 32.e87 (pii)