Patient-Reported Financial Burden in Head and Neck Cancer Undergoing Radiotherapy.

Area of Science:

• Oncology
• Health Economics
• Patient Advocacy

Background:

• Financial toxicity (FT) poses a significant burden on cancer patients, particularly those with head and neck cancer (HNC) due to treatment costs and reduced work capacity.
• Head and neck cancer patients often face substantial out-of-pocket payments (OOPP) and challenges in returning to work, increasing their vulnerability to financial toxicity.
• Understanding the prevalence and types of OOPP is crucial for developing strategies to mitigate financial toxicity in HNC survivors.

Purpose of the Study:

• To assess the prevalence and types of out-of-pocket payments (OOPP) among head and neck cancer (HNC) patients post-radiotherapy in Romania.
• To evaluate the extent of financial toxicity (FT) experienced by these patients using a validated instrument.
• To identify patient characteristics and factors associated with financial toxicity in this population.

Main Methods:

• A cross-sectional study involving 113 head and neck cancer (HNC) patients who completed curative radiotherapy in Romania.
• Data collection through a 25-item questionnaire on sociodemographics, insurance, income, and OOPP, alongside the validated nine-item Financial Index of Toxicity (FIT) scale.
• Statistical analyses including descriptive statistics, chi-square tests, t-tests, and ANOVA to determine associations, with a significance level of p < 0.05.

Main Results:

• Nearly 40% of HNC patients experienced financial toxicity (FT), with 29.2% reporting high financial stress.
• Transportation and nutritional supplements were the most common out-of-pocket expenses (OOPP), with 42% spending over a month's minimum wage on transportation.
• FT was significantly associated with employment and marital status, but not with tumor site or treatment modality.

Conclusions:

• Romanian HNC patients undergoing curative radiotherapy face considerable OOPP, especially for transportation and nutritional support.
• While overall FT levels were moderate, divorced patients and those retired due to chronic conditions exhibited higher vulnerability.
• Addressing FT through financial counseling and improved social support is essential to enhance treatment adherence, survival, and quality of life for HNC patients.