Relationship between the cancer-specific comprehensive score for financial toxicity (COST), patient-reported outcome, and health-related quality of life (HRQOL) in patients with advanced cancers.

Abstract

222 Background: Financial toxicity is an important Patient Reported Outcome (PRO). Its relationship with HRQOL has not been previously described. Therefore, we report the relationship between financial toxicity and HRQOL in patients with advanced cancers. Methods: HRQOL was measured by the EORTC QLC-C30 global health status and its functional scales. Financial toxicity was assessed by the COST (COmprehensive Score for financial Toxicity), a cancer-specific PRO measure developed in 155 patients with advanced cancers. The Personal Financial Wellness Scale (PFW), a non-cancer specific financial measure, as well as the EORTC perceived financial impact (FI), were used to assess convergent validity. The Marlowe-Crowne Social Desirability Scale and the Brief Profile of Mood States were included to demonstrate divergent validity (i.e., no significant relationship should exist between self-reported financial toxicity and social desirability and total mood disturbance). Spearman’s correlation coefficients were used to assess the strength of relationships. Results: Fifty patients were assessed. All participants were diagnosed with advanced cancers, were receiving treatment at the time of participation, and had received treatment for at least 3 months. A negative correlation existed between the COST and HRQOL as measured by the EORTC (r = -0.32, p < 0.05). The highest correlation was found between COST and the EORTC Emotional Functioning Scale (r = - 0.34, p < 0.05). The COST had high correlations with the PFW scale (r = 0.86, p<0.0001) and FI (r = 0.74, p < 0.0001), indicating convergent validity. The association between financial toxicity and social desirability and mood states were not statistically significant (r = 0.16, p = 0.28 and 0.20, p = 0.15, respectively), indicating divergent validity. Conclusions: Results demonstrate an inverse relationship between patient-reported HRQOL and financial toxicity, suggesting that higher financial toxicity is associated with worse HRQOL in this small sample of patients. There was no correlation between COST and social desirability and mood disturbances, as expected.