Skip to main content
Top
Published in: Breast Cancer Research and Treatment 1/2020

01-01-2020 | Breast Cancer | Epidemiology

Racial differences in employment and cost-management behaviors in patients with metastatic breast cancer

Authors: Cleo A. Samuel, Jennifer C. Spencer, Donald L. Rosenstein, Katherine E. Reeder-Hayes, Michelle L. Manning, Jean B. Sellers, Stephanie B. Wheeler

Published in: Breast Cancer Research and Treatment | Issue 1/2020

Login to get access

Abstract

Purpose

Little is known about racial variations in the financial impact of cancer care. Using data from a national survey of racially diverse patients with metastatic breast cancer, we examined racial/ethnic patterns in employment and cost-management (i.e., financial coping) behaviors.

Methods

We conducted an online survey of patients with metastatic breast cancer. Participants reported on socio-demographic characteristics, employment, and financial coping behaviors. We employed adjusted modified Poisson regressions to evaluate racial/ethnic differences in changes in work for pay and financial coping.

Results

Our analysis included 1052 respondents from 41 states, including Non-Hispanic Blacks (NHB, 9%), Hispanics (7%), Asians/Pacific Islanders/Native Hawaiians (API/NH, 10%), American Indians/Alaskan Natives (AI/AN, 8%), and Non-Hispanic Whites (NHW, 66%). In adjusted analyses comparing NHWs with patients of color, patients of color were more likely to take unpaid leave (NHB Adjusted Risk Ratio [ARR] = 2.27; 95% CI 1.54, 3.34), take paid leave (Hispanic ARR = 2.27; 95% CI 1.54, 1.29), stop work (AI/AN ARR = 1.22; 95% CI 1.05, 1.41), and reduce work hours (AI/AN ARR = 1.33; 95% CI 1.14, 1.57). Patients of color were more likely than NHWs to stop treatment (NHB ARR = 1.22; 95% CI 1.08, 1.39), borrow money from friends/family (Hispanic ARR = 1.75; 95% CI 1.25, 2.44), skip other medical bills (API/NH ARR = 2.02; 95% CI 1.54, 2.63), and skip non-medical bills (AI/AN ARR = 1.67 95% CI 1.06, 2.63). Non-Hispanic Whites more commonly reported using savings or skipping a vacation to help manage costs.

Conclusions

Racial/ethnic differences exist in employment changes and financial coping among metastatic breast cancer patients, with patients of color experiencing worse consequences. Equity must be a guiding principle in strategies addressing financial burden during cancer care.
Appendix
Available only for authorised users
Literature
4.
go back to reference Zafar SY (2016) Financial toxicity of cancer care: it’s time to intervene. J. Natl, Cancer Inst, p 108 Zafar SY (2016) Financial toxicity of cancer care: it’s time to intervene. J. Natl, Cancer Inst, p 108
15.
go back to reference Altice CK, Banegas MP, Tucker-Seeley RD, Yabroff KR (2017) Financial hardships experienced by cancer survivors: a systematic review. J. Natl, Cancer Inst, p 109 Altice CK, Banegas MP, Tucker-Seeley RD, Yabroff KR (2017) Financial hardships experienced by cancer survivors: a systematic review. J. Natl, Cancer Inst, p 109
18.
go back to reference Bureau-of-Labor-Statistics, U. (2015) Labor force characteristics by race and ethnicity, 2014. US Bur Labor Stat Bureau-of-Labor-Statistics, U. (2015) Labor force characteristics by race and ethnicity, 2014. US Bur Labor Stat
20.
go back to reference Jeszeck C (2015) Contingent workforce: size, characteristics, earnings, and benefits (GAO-15-168R). Washington, DC Jeszeck C (2015) Contingent workforce: size, characteristics, earnings, and benefits (GAO-15-168R). Washington, DC
23.
go back to reference Bickell NA, LePar F, Wang JJ, Leventhal H (2007) Lost opportunities: physicians’ reasons and disparities in breast cancer treatment. J Clin Oncol 25:2516–2521CrossRef Bickell NA, LePar F, Wang JJ, Leventhal H (2007) Lost opportunities: physicians’ reasons and disparities in breast cancer treatment. J Clin Oncol 25:2516–2521CrossRef
24.
go back to reference Bickell NA (2002) Race, ethnicity, and disparities in breast cancer: victories and challenges. Women’s Heal Issues 12:238–251CrossRef Bickell NA (2002) Race, ethnicity, and disparities in breast cancer: victories and challenges. Women’s Heal Issues 12:238–251CrossRef
Metadata
Title
Racial differences in employment and cost-management behaviors in patients with metastatic breast cancer
Authors
Cleo A. Samuel
Jennifer C. Spencer
Donald L. Rosenstein
Katherine E. Reeder-Hayes
Michelle L. Manning
Jean B. Sellers
Stephanie B. Wheeler
Publication date
01-01-2020
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-019-05449-9

Other articles of this Issue 1/2020

Breast Cancer Research and Treatment 1/2020 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine