Financial burden in advanced cancer: colorectal cancer data analysis

To characterise patient-reported financial burden of living with advanced colorectal cancer in Alberta, Canada, as part of a larger prospective cohort study characterising the experiences of people living with advanced colorectal cancer.

Patients were recruited from Alberta's tertiary cancer centres between January 2018 and July 2020. Enrolled participants were invited to complete the Patient Self-Administered Financial Effects (P-SAFE) questionnaire at 1 month post-enrolment and every 6 months thereafter, until death or end of study (December 2020). The questionnaire captured consumption expenditure, out-of-pocket costs, including travel and parking costs, dissaving strategies and productivity impacts of patients and caregivers over the past 28 days.

Of 87 eligible patients, 56 completed at least one P-SAFE survey. They reported an average of $C401 in out-of-pocket costs (eg, medications, vitamins/supplements, devices) over the past 28 days (median $C84, range $C0-$C4475), plus an average of $C249 per 28 days for travel and parking (median $C80, range $C0-$C2680). Patients reported an average of two trips per month to their cancer centre, travelling anywhere from 6 to 500 km one way. 88% of employed patients and 88% of employed caregivers reported impacts on employment; 34% of patients made significant asset decisions (eg, withdrew savings, downsized home). 30% of patients reported high perceived financial burden (ie, 'somewhat', 'large' or 'worst possible' financial difficulty) in the past month.

This cross-sectional descriptive analysis suggests that the financial burden of advanced colorectal cancer is high, as evidenced by high out-of-pocket costs, impacts on employment and self-reported financial difficulty.