Financial toxicity, financial well-being, and quality of life among bladder cancer patients.

Abstract

133 Background: Due to a long course of surveillance, and for some patients, multimodal therapy with chemotherapy and surgery, bladder cancer (BC) can present a financial burden to the household. Yet, there are several terms used to describe this burden such as financial hardship and financial toxicity (FT); and it is unclear whether different measures of financial circumstances are correlated and whether they are associated with quality of life (QOL). The goal of this study was to determine whether FT and financial well-being (FWB) were correlated and to determine whether FT and FWB were similarly associated with QOL among BC patients. Methods: Patients that had BC treatment in the last 2 years were recruited from two NCI designated cancer centers for our study (N = 100). The Comprehensive Score for Financial Toxicity (COST) was used to assess FT, the Consumer Financial Protection Bureau’s (CFPB) FWB measure was used to assess FWB, and a BC-specific Functional Assessment of Cancer Therapy (FACT) questionnaire was used to assess physical, social, emotional, and functional domains of QOL. Bivariate analyses were conducted to determine the association among FT, FWB, and QOL; and separate logistic regression analyses predicting FT and FWB were used to determine the association between FT and FWB and each domain of QOL. Results: Bivariate results showed that FT and FWB were highly negatively correlated (r = -.76; p < .0001); however, only FWB was correlated with the total QOL score (p < .05). FT was correlated with physical (p < .01), emotional (p < .05), and functional (p < .05) QOL; and FWB was correlated with physical (p < .05) and functional (p < .05) QOL. Logistic regression models adjusted for socioeconomic and demographic characteristics showed that those reporting higher physical QOL (OR = 1.18; CI: 1.04-1.35) and higher functional QOL (OR = 1. 15; CI: 1.03-1.28) had higher odds of reporting high FWB. Conclusions: Given the surveillance and treatment processes for BC patients, it is important to better understand their financial circumstances as they are navigating and managing care. Our results suggest that physical and functional QOL is relevant for predicting FWB, but after considering socioeconomic and demographic characteristics, no domain of QOL was a significant predictor of FT among BC patients.