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Beyond the Tumor: Exploring the Financial Toxicity of Non-Muscle Invasive Bladder Cancer in a Diverse, Urban
Julia Nadelmann1, Andrewe L Baca2, Kevin Labagnara1
1Albert Einstein College of Medicine, Bronx, NY.
Purpose:
To characterize financial toxicity (FT) of non-muscle invasive bladder cancer (NMIBC) among our uniquely diverse and urban population.
Materials And Methods:
We surveyed a cohort of patients at our institution with NMIBC using the validated COST tool (COmprehensive Score for financial Toxicity). Scores are inversely correlated to the degree of FT. Scores of 25-14 indicated "Mild FT" and < 14 indicated "Moderate FT". Demographic and disease specific information were collected. Statistical analysis was performed using SPSS.
Results:
Hundred patients with NMIBC were surveyed. The median age was 74 years (IQR, 66-79). A total of 39% were female; 35% identified as Caucasian, 26% as Black, and 37% as Hispanic. The median COST score was 23 (IQR,15-33). 61% of patients reported at least mild FT (COST score 25-14). A total of 21% reported moderate FT (COST score < 14). Black patients were more likely to experience FT than Caucasians (73% vs 37%, P < .05). Caucasian patients had a mean COST score 8 points higher than all other races combined (P < .01). Overall median household income was $30,000 (IQR, $18,250-$60,750), and increasing income had a significant positive correlation with COST score (Spearman ρ = 0.502, P < .001). Risk factors for FT included non-Caucasian race and lower education level.
Conclusion:
In a diverse, urban population, rates of FT among NMIBC patients were higher than previously reported. FT may disproportionately affect non-Caucasian patients and may be related to decreased access to care. These results highlight the need to further assess and address FT in NMIBC patients.
