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Financial Toxicity Survey in Patients With Gynecologic Cancer.

Alana Lanser1, Indira Pachipala1, Rachael Piver1

  • 1Georgia Cancer Center and the Department of Obstetrics and Gynecology, Medical College of Georgia at Augusta University, and the Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, Georgia.

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|September 26, 2025
PubMed
Summary
This summary is machine-generated.

The Comprehensive Score for Financial Toxicity (COST) survey effectively predicts financial hardship in gynecologic cancer patients. A COST score of 26 or higher indicates a high likelihood of patients facing financial distress.

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Area of Science:

  • Oncology
  • Health Economics
  • Social Determinants of Health

Background:

  • Cancer care costs can lead to significant financial strain for patients.
  • Financial toxicity is a growing concern impacting treatment adherence and quality of life.

Purpose of the Study:

  • To evaluate the Comprehensive Score for Financial Toxicity (COST) survey's accuracy in identifying patients with gynecologic cancer experiencing financial hardship.
  • To determine the sensitivity, specificity, and predictive values of the COST survey.

Main Methods:

  • A cross-sectional study involving 323 patients with gynecologic cancer within 5 years of diagnosis or recurrence.
  • Patients completed the COST survey and were screened for financial distress indicators (altered spending, borrowing, medication non-adherence, food insecurity).

Main Results:

  • The COST survey demonstrated strong predictive capability with an area under the curve of 0.92.
  • A COST score cutoff of 26 yielded 83.1% sensitivity and 88.2% specificity for predicting financial hardship.
  • Positive and negative predictive values at this cutoff were 92.9% and 73.7%, respectively.

Conclusions:

  • The COST score is a reliable measure of financial toxicity in gynecologic cancer patients.
  • The COST score is associated with social determinants of health and can help predict needs beyond financial assistance.