LATEBREAKER
Cancer
Sociodemographic Factors and Financial Toxicity among Cancer Patients and Survivors: A Nationwide Study in Japan Kaori Suga* Kaori Suga Yuri Ito Kosuke Inoue Yuichi Ichinose Takahiro Higashi Naoki Kondo
Background: Financial toxicity (FT) refers to increased risk of treatment discontinuation and anxiety experienced in daily life due to the cost burden of cancer treatment. FT is reportedly linked to decreased quality of life and increased mortality, but few studies have thoroughly examined patient demographics among different age groups, especially in countries with Universal Health Coverage (UHC). We aimed to explore patient demographics and living conditions associated with FT, among adult cancer patients in Japan, which has UHC, and identify factors strongly linked to FT.
Methods: We analyzed responses from the Patient Experience Survey, a self-administered questionnaire conducted by the National Cancer Center in 2018. Patients were categorized as “have FT” if they agreed with one or both statements: “Changed or discontinued treatment” or “Impact on treatment and life (10 items)” due to treatment cost. We used weighted analysis to ensure representation of the target population—patients who started cancer treatment in 2016, used a modified Poisson regression model to analyze the association between patient demographics and FT, estimated the Prevalence Ratio (PR) and conducted subgroup analysis by sex.
Results: Of 6,783 valid responses (3,529 men, 3,254 women) 29.2% of men and 32.2% of women reported FT. Results of the multivariate analysis among both sexes showed a high PR of FT was associated with younger age, malignant lymphoma/leukemia, during treatment, chemotherapy, taking leave or retiring due to treatment, absence of consultants, feeling alienated, and experiencing prejudice. Age at diagnosis was higher for under 39s (vs 65+) PR= 1.82 [95% CI, 1.48-2.23] for men and PR= 1.41 [95% CI, 1.20-1.65] for women.
Conclusion: These results show the need for counseling support and a better work-treatment balance for cancer patients. They also highlight the importance of improving the social environment to help patients and survivors maintain connections with society.