Financial toxicity among head and neck cancer patients and their caregivers: A cross‐sectional pilot study

• Published in: Laryngoscope investigative otolaryngology Vol. 8; no. 2; pp. 450 - 457
• Main Authors: Nguyen, Oliver T., Donato, Umberto, McCormick, Rachael, Reblin, Maija, Kim, Lindsay, Hume, Emma, Otto, Amy K., Alishahi Tabriz, Amir, Islam, Jessica Y., Hong, Young‐Rock, Turner, Kea, Patel, Krupal B.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.04.2023; Wiley
• Subjects: Cancer therapies; Caregivers; Clinical outcomes; Consent; Ethnicity; Family income; Feasibility studies; financial burden; financial toxicity; Head & neck cancer; head and neck cancer; Head and Neck, and Tumor Biology; Health insurance; Hispanic Americans; Households; Missing data; Original Research; Patients; Questionnaires; caregivers; financial toxicity; head and neck cancer; financial burden
• ISSN: 2378-8038; 2378-8038
• DOI: 10.1002/lio2.1038

Objectives Head and neck cancer (HNC) patients experience greater financial toxicity than other cancer patients. Research on financial toxicity has concentrated on patients despite many informal caregivers sharing finances and reducing work hours to provide patient care. Thus, our pilot study: (1) assessed the feasibility of financial toxicity screening of HNC patients and their caregivers, and (2) described financial toxicity levels of HNC patients and their caregivers. Methods We surveyed English‐speaking adult HNC patients initiating treatment at a National Cancer Institute‐designated Comprehensive Cancer Center and their informal caregivers. This survey assessed demographics and financial toxicity through the Comprehensive Score for Financial Toxicity (COST) measure (0–44 range; lower score indicates higher financial toxicity). Screening feasibility was defined as ≥50% consent rate and ≥60% data completion rate. Results Our sample included 27 HNC patients and 9 caregivers. They both had slightly lower consent and completion rates than our goals. Patients reported a median COST score of 27 while caregivers reported a median COST score of 16. Approximately 25.9% of patients and 44.4% of caregivers reported high financial toxicity (COST < 17.5). Caregivers reported high concerns about their future financial health and their ability to control the amount of their financial contributions to the patient's care. Conclusions Patients and caregivers may require additional outreach approaches beyond emailed questionnaires to screen for their financial toxicity systematically. Future research is needed to replicate our results to determine whether differences in financial toxicity occur between patients and caregivers and identify areas of focus for interventions. Level of evidence IV. Our pilot study administered the Comprehensive Score for Financial Toxicity (COST) measure to head and neck cancer patients and their caregivers. We found that approximately 25.9% of patients and 44.4% of caregivers reported high financial toxicity (COST<17.5). Caregivers reported high concerns about their future financial health and their ability to control the amount of their financial contributions to the patient's care.