Screening for Financial Toxicity and Health-Related Social Risks in Patients With GI Cancer: Results From a Large...

Area of Science:

• Oncology
• Health Services Research
• Health Economics

Background:

• Gastrointestinal (GI) cancer patients frequently experience significant financial toxicity (FT) and health-related social risks (HRSRs).
• Current best practices for screening and managing these burdens remain unclear, necessitating further investigation.

Purpose of the Study:

• To evaluate the prevalence of FT and HRSR among patients with GI cancer.
• To identify factors associated with the presence and severity of FT and HRSR in this population.

Main Methods:

• A prospective study screened 8,335 GI cancer patients from June 2022 to August 2023.
• Screening tools included the Comprehensive Score for Financial Toxicity (COST), patient-reported HRSRs (e.g., housing, food insecurity), and quality of life (QOL) measures.
• Multivariate regression analyses were employed to identify predictors of FT and HRSR, controlling for relevant variables.

Main Results:

• 45% of patients reported FT (COST score <26). FT was linked to minority status, advanced disease, recent treatment, and specific cancer types (anal, esophageal, hepatobiliary).
• Protective factors against FT included older age, higher income, and private insurance.
• 28% reported at least one HRSR, associated with minority status, advanced disease, recent treatment, and gastric cancer. Older age, higher income, and private insurance were protective against HRSRs. FT negatively impacted QOL and medication adherence.

Conclusions:

• High rates of financial toxicity and health-related social risks are prevalent in GI cancer patients.
• Early interventions targeting financial and social challenges are crucial for improving patient outcomes and survivorship.