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Supportive Care in Cancer
Published in: Supportive Care in Cancer 2/2016

01-02-2016 | Original Article

Pre-diagnosis employment status and financial circumstances predict cancer-related financial stress and strain among breast and prostate cancer survivors

Authors: Linda Sharp, Aileen Timmons

Published in: Supportive Care in Cancer | Issue 2/2016

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Abstract

Purpose

Cancer may have a significant financial impact on patients, but the characteristics that predispose patients to cancer-related financial hardship are poorly understood. We investigated factors associated with cancer-related financial stress and strain in breast and prostate cancer survivors in Ireland, which has a complex mixed public-private healthcare system.

Methods

Postal questionnaires were distributed to 1373 people diagnosed with cancer 3–24 months previously identified from the National Cancer Registry Ireland. Outcomes were cancer-related financial stress (impact of cancer diagnosis on household ability to make ends meet) and financial strain (concerns about household financial situation since cancer diagnosis). Modified Poisson regression was used to estimate relative risks (RR) for factors associated with cancer-related financial stress and strain.

Results

Seven hundred forty survivors participated (response rate = 54 %). Of the respondents, 48 % reported cancer-related financial stress and 32 % cancer-related financial strain. Compared to those employed at diagnosis, risk of cancer-related financial stress was significantly lower in those not working (RR = 0.71, 95 % CI 0.58–0.86) or retired (RR = 0.48, 95 % CI 0.34–0.68). It was significantly higher in those who had dependents; experienced financial stress pre-diagnosis; had a mortgage/personal loans; had higher direct medical out-of-pocket costs; and had increased household bills post-diagnosis. For cancer-related financial strain, significant associations were found with dependents, pre-diagnosis employment status and pre-diagnosis financial stress; risk was lower in those with higher direct medical out-of-pocket costs.

Conclusions

Cancer-related financial stress and strain are common. Pre-diagnosis employment status and financial circumstances are important predictors of post-diagnosis financial wellbeing. These findings could inform development of tools to identify patients/survivors most in need of financial advice and support.
Appendix
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Literature
1.
Longo CJ, Deber R, Fitch M, Williams AP, D’Souza D (2007) An examination of cancer patients’ monthly’out-of-pocket’ costs in Ontaria, Canada. Eur J Cancer Care 16:500–507CrossRef
2.
Lauzier S, Maunsell E, Drolet M, Coyle D, Hebert-Croteau N, Brisson J, Masse B, Abdous B, Robidoux A, Roberts J (2008) Wage losses in the year after breast cancer: extent and determinants among Canadian women. J Natl Canser Inst 100:332
3.
Pisu M, Azuero A, McNees P, Burkhardt J, Benz R, Meneses K (2010) The out of pocket cost of breast cancer survivors: a review. J Cancer Surviv 4:202–209PubMedPubMedCentralCrossRef
4.
Lauzier S, Levesque P, Drolet M, Coyle D, Brisson J, Mâsse B, Robidoux A, Robert J, Maunsell E (2011) Out-of-pocket costs for accessing adjuvant radiotherapy among Canadian women with breast cancer. J Clin Oncol 29:4007–4013PubMedCrossRef
5.
Longo CJ, Bereza BG (2011) A comparative analysis of monthly out-of-pocket costs for patients with breast cancer as compared with other common cancers in Ontario, Canada. Curr Oncol 18:e1–e8PubMedPubMedCentralCrossRef
6.
Housser E, Mathews M, Lemessurier J, Young S, Hawboldt J, West R (2013) Responses by breast and prostate cancer patients to out-of-pocket costs in Newfoundland and Labrador. Curr Oncol 20:158–165PubMedPubMedCentralCrossRef
7.
Lauzier S, Levesque P, Mondor M, Drolet M, Coyle D, Brisson J, Masse B, Provencher L, Robidoux A, Maunsell E (2013) Out-of-pocket costs in the year after early breast cancer among Canadian women and spouses. J Natl Cancer Inst 105:280–292PubMedCrossRef
8.
Timmons A, Gooberman-Hill R, Sharp L (2013) The multidimensional nature of the financial and economic burden of a cancer diagnosis on patients and their families: qualitative findings from a country with a mixed public-private healthcare system. Support Care Cancer 21:107–117PubMedCrossRef
9.
Longo CJ, Fitch M, Deber RB, Williams AP (2006) Financial and family burden associated with cancer treatment in Ontario, Canada. Support Care Cancer 14:1077–1085PubMedCrossRef
10.
Pisu M, Azuero A, Meneses K, Burkhardt J, McNees P (2011) Out of pocket cost comparison between Caucasian and minority breast cancer survivors in the Breast Cancer Education Intervention (BCEI). Breast Cancer Res Treat 127:521–529PubMedPubMedCentralCrossRef
11.
de Oliveira C, Bremner KE, Ni A, Alibhai SM, Laporte A, Krahn MD (2014) Patient time and out-of-pocket costs for long-term prostate cancer survivors in Ontario, Canada. J Cancer Surviv 8:9–20PubMedCrossRef
12.
13.
de Souza JA, Wong YN (2013) Financial distress in cancer patients. J Med Person 11:10.1007CrossRef
14.
Valtorta NK, Hanratty B (2013) Socioeconomic variation in the financial consequences of ill health for older people with chronic diseases: a systematic review. Maturitas 74:313–333PubMedCrossRef
15.
Kent EE, Forsythe LP, Yabroff KR, Weaver KE, de Moor JS, Rodriguez JL, Rowland JH (2013) Are survivors who report cancer-related financial problems more likely to forgo or delay medical care? Cancer 119:3710–3717PubMedPubMedCentralCrossRef
16.
Zucca A, Boyes A, Newling G, Hall A, Girgis A (2011) Travelling all over the countryside: travel-related burden and financial difficulties reported by cancer patients in New South Wales and Victoria. Aust J Rural Health 19:298–305PubMedCrossRef
17.
Shankaran V, Jolly S, Blough D, Ramsey SD (2012) Risk factors for financial hardship in patients receiving adjuvant chemotherapy for colon cancer: a population-based exploratory analysis. J Clin Oncol 30:1608–1614PubMedCrossRef
18.
Francoeur RB (2005) Cumulative financial stress and strain in palliative radiation outpatients: the role of age and disability. Acta Oncol 44:369–381PubMedPubMedCentralCrossRef
19.
Hanratty B, Holland P, Jacoby A, Whitehead M (2007) Financial stress and strain associated with terminal cancer-a review of the evidence. Palliat Med 21:595–607PubMedCrossRef
20.
Lipscomb J, Gotay CC, Snyder CF (2007) Patient-reported outcomes in cancer: a review of recent research and policy initiatives. CA Cancer J Clin 57:278–300PubMedCrossRef
21.
Maddams J, Brewster D, Gavin A, Steward J, Elliott J, Utley M, Møller H (2009) Cancer prevalence in the United Kingdom: estimates for 2008. Br J Cancer 101:541–547PubMedPubMedCentralCrossRef
22.
Siegel R, DeSantis C, Virgo K, Stein K, Mariotto A, Smith T, Cooper D, Gansler T, Lerro C, Fedewa S, Lin C, Leach C, Cannady RS, Cho H, Scoppa S, Hachey M, Kirch R, Jemal A, Ward E (2012) Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin 62:220–241PubMedCrossRef
23.
Sharp L, Deady S, Gallagher P, Molcho M, Pearce A, Thomas AA, Timmons A, Comber H (2014) The magnitude and characteristics of the population of cancer survivors: using population-based estimates of cancer prevalence to inform service planning for survivorship care. BMC Cancer 14:767PubMedPubMedCentralCrossRef
24.
Smith S, Normand C (2011) Equity in health care: the Irish perspective. Health Econ Policy Law 6:205–217PubMedCrossRef
25.
Timmons A, Gooberman-Hill R, Sharp L (2013) “It’s a time in your life when you are most vulnerable”: a qualitative exploration of the financial impact of a cancer diagnosis and implications for financial protection in health. PLoS One 8(11):1–11CrossRef
26.
McDevitt J, Sharp L, MacDonald D, Dwane F, Comber H (2013) Factors affecting receipt of a medical card in a cohort of colorectal cancer patients, 2002–2006. Ir Med J 106:110–113PubMed
27.
28.
O’Brien K, Comber H, Sharp L (2014) Completeness of case ascertainment at the Irish National Cancer Registry. Ir J Med Sci 183(2):219–224PubMedCrossRef
29.
Zou G (2004) A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol 159:702–706PubMedCrossRef
30.
31.
Pukkala E, Weiderpass E (1999) Time trends in socio-economic differences in incidence rates of cancers of the breast and female genital organs (Finland, 1971–1995). Int J Cancer 81:56–61PubMedCrossRef
32.
33.
Azzani M, Roslani AC, Su TT (2015) The perceived cancer-related financial hardship among patients and their families: a systematic review. Support Care Cancer 23:889–898PubMedCrossRef
34.
Zafar SY, Peppercorn JM, Schrag D, Taylor DH, Goetzinger AM, Zhong X, Abernethy AP (2013) The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient’s experience. Oncologist 18:381–390PubMedPubMedCentralCrossRef
35.
Carp F, Carp A (1982) Test of a model of domain satisfaction and well-being. Equity considerations. Res Aging 4:503–522CrossRef
36.
Fletcher C, Lorenz F (1985) Structural influences on the relationship between objective and subjective indicators of economic well-being. Soc Indic Res 16:333–345CrossRef
37.
38.
Arozullah AM, Calhoun EA, Wolf M, Finley DK, Fitzner KA, Heckinger EA, Gorby NS, Schumock GT, Bennett CL (2004) The financial burden of cancer: estimates from a study of insured women with breast cancer. J Support Oncol 2:271–278PubMed
39.
Baider L, Andritsch E, Uziely B, Ever-Hadani P, Goldzweig G, Hoffman G, Samonigg H (2003) Do different cultural settings affect the psychological distress of women with breast cancer? A randomized study. Eur J Cancer Care 12:263–273CrossRef
40.
Ell K, Xie B, Wells A, Nedjat-Haiem F, Lee PJ, Vourlekis B (2008) Economic stress among low-income women with cancer: effects on quality of life. Cancer 112:616–625PubMedCrossRef
41.
42.
Lee MK, Park S, Lee ES, Ro J, Kang HS, Shin KH, Lee KS, Chung KW, Kim SW, Yun YH (2010) Social support and depressive mood 1 year after diagnosis of breast cancer compared with the general female population: a prospective cohort study. Support Cancer Care 2011; 19:1379–92
43.
Ceilleachair AO, Costello L, Finn C, Timmons A, Fitzpatrick P, Kapur K, Staines A, Sharp L (2012) Inter-relationships between the economic and emotional consequences of colorectal cancer for patients and their families: a qualitative study. BMC Gastroenterol 12:62PubMedCrossRef
44.
Fenn KM, Evans SB, McCorkle R, DiGiovanna MP, Pusztai L, Sanft T, Hofstatter EW, Killelea BK, Knobf MT, Lannin DR, Abu-Khalaf M, Horowitz NR, Chagpar AB (2014) Impact of financial burden of cancer on survivors’ quality of life. J Oncol Pract 10:332–338PubMedCrossRef
45.
Adams J, White M, Moffatt S, Howel D, Mackintosh J (2006) A systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings. BMC Public Health 6:81PubMedPubMedCentralCrossRef
46.
O’Neill B, Prawitz AD, Sorhaindo B, Kim J, Garman T (2006) Changes in health, negative financial events, and financial distress/financial wellbeing for debt management program clients. Financ Couns Plann 17:46–62
47.
Rajurkar SP, Presant CA, Bosserman LD, McNatt WJ (2011) A copay foundation assistance program for patients receiving intravenous cancer therapy. J Oncol Pract 7:100–102PubMedPubMedCentralCrossRef
48.
Moffatt S, Noble E, White M (2012) Addressing the financial consequences of cancer: qualitative evaluation of a welfare rights advice service. PLoS One 7, e42979PubMedPubMedCentralCrossRef
49.
Pisu M, Martin MY, Shewchuk R, Meneses K (2014) Dealing with the financial burden of cancer: perspectives of older breast cancer survivors. Support Care Cancer 22:3045–3052PubMedPubMedCentralCrossRef
50.
Morreno-Serra R, Millett C, Smith PC (2011) Towards improved measurement of financial protection in health. PLoS Med 8:1–6CrossRef
51.
Maunsell E, Brisson C, Dubois L, Lauzier S, Fraser A (1999) Work problems after breast cancer: an exploratory qualitative study. Psychooncology 8:467–473PubMedCrossRef
52.
Steiner JF, Cavender TA, Main DS, Bradley CJ (2004) Assessing the impact of cancer on work outcomes. What are the research needs? Cancer 101:1703–1711PubMedCrossRef
53.
de Boer AG, Taskila T, Tamminga SJ, Frings-Dresen MH, Feuerstein M, Verbeek JH (2011) Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev 2, CD007569PubMed
Metadata
Title
Pre-diagnosis employment status and financial circumstances predict cancer-related financial stress and strain among breast and prostate cancer survivors
Authors
Linda Sharp
Aileen Timmons
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 2/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2832-4

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