Introduction:

Financial toxicity (FT) refers to a multi-dimensional, patient reported financial hardship related to cancer care. It is associated with decreased QoL, delaying and/or forgoing care and even decreased survival. Herein we explored the association between clinicopathologic and sociodemographic characteristics and validated measures of FT and financial well-being (FWB) in a diverse sample of bladder cancer patients. 

Methods:

Patients with a diagnosis of urothelial bladder cancer for equal to or greater than 6 months were recruited from an NCI designated cancer center and a large public safety-net hospital (N=100). The Comprehensive Score for Financial Toxicity (COST) was used to assess FT, the Consumer Financial Protection Bureau (CFPB) was used to assess FWB, and a BC-specific Functional Assessment of Cancer Therapy (FACT) questionnaire was used to assess QOL. Additional data were abstracted from the medical record and participants. Bivariate analyses to determine the association between these and FT, FWB, and QOL. Simple and fully adjusted logistic regression analyses predicting FT and FWB were used to determine the association between each of these measures and each domain of QOL.

Results:

The sample was clinically and demographically diverse (Table 1). Being non-white, non-English speaking, lower education, and receiving care at the public hospital were associated with higher FT and lower FWB scores (Fig. 2). No clinicopathologic variables correlated to FT scores, and only receipt of neoadjuvant chemotherapy was weakly correlated to FWB scores (r=0.22, p=0.03). There was a positive correlation between CFPB score and physical health (r=.250, p=.024), and functional health (r=.241, p=.031). COST score was correlated with physical health (r=.331, p=.005), and emotional health (r=.317, p=.007).

Conclusion:

BC patients who were non-white, non-English-speaking, lower education and were receiving care at a public vs. private center endorsed higher FT and lower FWB. In this clinically heterogeneous sample, clinicopathologic factors did not predict FT. 

Funding: This work was funded by the Bladder Cancer Advocacy Network