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Cited by 84Economic and Financial Impacts of CancerCancer survivorship and careCancer-related cognitive impairment studies

Correlates of financial toxicity in adult cancer patients and their informal caregivers

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Sadigh, Gelareh, Switchenko, Jeffrey, Weaver, Kathryn E., Elchoufi, Deema, Meisel, Jane, Bilen, Mehmet Asim, Lawson, David, Cella, David +2 more·2022·Supportive Care in Cancer
DOI 10.1007/s00520-021-06424-1PMC PMC8639637
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Abstract

Background Financial toxicity is commonly reported by cancer patients, but few studies have assessed caregiver perceptions. We aimed to validate the modified Comprehensive Score for Financial Toxicity (COST) in cancer caregivers, identify factors associated with financial toxicity in both patients and caregivers, and assess the association of caregiver financial toxicity with patient and caregiver outcomes. Methods Using a convenience sampling method, 100 dyads of adult cancer patients and a primary caregiver visiting outpatient oncology clinics (Jan-Sep 2019) were recruited. We assessed the internal consistency and convergent and divergent validity of the modified COST. Multivariable analyses identified correlates of financial toxicity. Association of financial toxicity with care non-adherence, lifestyle-altering behaviors (e.g., home refinance/sale, retirement/saving account withdrawal), and quality of life (QOL) was investigated. Results Recruited patient vs. caregiver characteristics were as follows: mean age: 60.6 vs. 56.5; 34% vs. 46.4% female; 79% vs. 81.4% white. The caregiver COST measure demonstrated high internal consistency (Cronbach α = 0.91). In patients, older age (B, 0.3 [95% CI, 0.1-0.4]) and higher annual household income (B, 14.3 [95% CI, 9.3-19.4]) correlated with lower financial toxicity (P < 0.05). In caregivers, lower patient financial toxicity (B, 0.4 [95% CI, 0.2-0.6]) and cancer stages 1-3 (compared to stage 4) (B, 4.6 [95% CI, 0.4-8.8]) correlated with lower financial toxicity (P < 0.05). Increased caregiver financial toxicity correlated with higher care non-adherence in patients, increased lifestyle-altering behaviors, and lower QOL in patients and caregivers (P < 0.05). Conclusion The COST measure can also be used to assess caregiver financial toxicity. Caregivers' financial toxicity was associated with negative outcomes for both dyad members.

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  • 10 studies described financial problems of caregivers, resulting from costs associated with the disease, lack of financial support of other family members, or difficulty reconciling role as caregivers with work activity.

    “In the economic sphere, 10 studies [25,27,39,44,53,56,57] described the financial problems of people caregivers, resulting from the costs associated with the disease, the lack of financial support of other family members, or the difficulty of reconciling their role as caregivers with their work activity.”

    From Quality of Life in Caregivers of Cancer Patients: A Literature Review (2023) · cites this paper as [56]

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Cited by

Sorted by citations

  • Quality of Life in Caregivers of Cancer Patients: A Literature Review

    Guerra-Martín, M. D., Casado-Espinosa, M. D. R., Gavira-López, Y., Holgado-Castro, C., López-Latorre, I., & Borrallo-Riego, Á. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20021570 · Cited by 80 · see citing works

    “, 2022 [56] (1) Validate the instrument Comprehensive Score for Financial Toxicity (COST) modified in non-professional caregivers of patients with cancer, (2) Identify factors associated with financial toxicity both in patients and caregivers, and (3) Evaluate the impact of financial toxicity in specific aspects of bo…”
    BackgroundInfluential

Authors
Sadigh, G., Switchenko, J., Weaver, K. E., Elchoufi, D., Meisel, J., Bilen, M. A., Lawson, D., Cella, D., El-Rayes, B., & Carlos, R.
Affiliations
  • Emory University (US)
  • Wake Forest University Health Sciences (US)
  • Duke University (US)
  • Winship Cancer Institute (US)
  • Northwestern University (US)
  • University of Michigan (US)
Corresponding author
Sadigh, Gelareh
ORCID
Venue
Supportive Care in Cancer
Publisher
Springer Science and Business Media LLC
Published
2021-07-13
Volume
30
Issue
1
Pages
217-225
ISSN
  • 0941-4355 (ISSN-L)
  • 1433-7339
DOI
10.1007/s00520-021-06424-1
PMC
PMC8639637
OpenAlex
W3178062719
Cited by
84
References
1
Citations by year
2026: 10 · 2025: 25 · 2024: 22 · 2023: 16 · 2022: 11
FWCI
9.35
Type
journal article
Language
en
Open access
Licence
Locations
  • Supportive Care in Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
Association of University Radiologists
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
Keywords
financial toxicity, cancer caregivers, informal caregivers, scale validation, caregiver burden, quality of life, household income, tumor stage, patient-caregiver dyads
MeSH terms
Financial Stress, Aged, Female, Humans, Male, Middle Aged, Neoplasms, Quality of Life, Caregivers

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