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Association of Financial Strain With Symptom Burden and Quality of Life for Patients With Lung or Colorectal Cancer.

Publication ,  Journal Article
Lathan, CS; Cronin, A; Tucker-Seeley, R; Zafar, SY; Ayanian, JZ; Schrag, D
Published in: J Clin Oncol
May 20, 2016

PURPOSE: To measure the association between patient financial strain and symptom burden and quality of life (QOL) for patients with new diagnoses of lung or colorectal cancer. PATIENTS AND METHODS: Patients participating in the Cancer Care Outcomes Research and Surveillance study were interviewed about their financial reserves, QOL, and symptom burden at 4 months of diagnosis and, for survivors, at 12 months of diagnosis. We assessed the association of patient-reported financial reserves with patient-reported outcomes including the Brief Pain Inventory, symptom burden on the basis of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30, and QOL on the basis of the EuroQoL-5 Dimension scale. Multivariable linear regression models were fit for each outcome and cancer type, adjusting for age, race/ethnicity, sex, income, insurance, stage at diagnosis, and comorbidity. RESULTS: Among patients with lung and colorectal cancer, 40% and 33%, respectively, reported limited financial reserves (≤ 2 months). Relative to patients with more than 12 months of financial reserves, those with limited financial reserves reported significantly increased pain (adjusted mean difference, 5.03 [95% CI, 3.29 to 7.22] and 3.45 [95% CI, 1.25 to 5.66], respectively, for lung and colorectal), greater symptom burden (5.25 [95% CI, 3.29 to .22] and 5.31 [95% CI, 3.58 to 7.04]), and poorer QOL (4.70 [95% CI, 2.82 to 6.58] and 5.22 [95% CI, 3.61 to 6.82]). With decreasing financial reserves, a clear dose-response relationship was present across all measures of well-being. These associations were also manifest for survivors reporting outcomes again at 1 year and persisted after adjustment for stage, comorbidity, insurance, and other clinical attributes. CONCLUSION: Patients with cancer and limited financial reserves are more likely to have higher symptom burden and decreased QOL. Assessment of financial reserves may help identify patients who need intensive support.

Duke Scholars

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

May 20, 2016

Volume

34

Issue

15

Start / End Page

1732 / 1740

Location

United States

Related Subject Headings

  • Quality of Life
  • Patient Reported Outcome Measures
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Cost of Illness
  • Colorectal Neoplasms
 

Citation

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Lathan, C. S., Cronin, A., Tucker-Seeley, R., Zafar, S. Y., Ayanian, J. Z., & Schrag, D. (2016). Association of Financial Strain With Symptom Burden and Quality of Life for Patients With Lung or Colorectal Cancer. J Clin Oncol, 34(15), 1732–1740. https://doi.org/10.1200/JCO.2015.63.2232
Lathan, Christopher S., Angel Cronin, Reginald Tucker-Seeley, S Yousuf Zafar, John Z. Ayanian, and Deborah Schrag. “Association of Financial Strain With Symptom Burden and Quality of Life for Patients With Lung or Colorectal Cancer.J Clin Oncol 34, no. 15 (May 20, 2016): 1732–40. https://doi.org/10.1200/JCO.2015.63.2232.
Lathan CS, Cronin A, Tucker-Seeley R, Zafar SY, Ayanian JZ, Schrag D. Association of Financial Strain With Symptom Burden and Quality of Life for Patients With Lung or Colorectal Cancer. J Clin Oncol. 2016 May 20;34(15):1732–40.
Lathan, Christopher S., et al. “Association of Financial Strain With Symptom Burden and Quality of Life for Patients With Lung or Colorectal Cancer.J Clin Oncol, vol. 34, no. 15, May 2016, pp. 1732–40. Pubmed, doi:10.1200/JCO.2015.63.2232.
Lathan CS, Cronin A, Tucker-Seeley R, Zafar SY, Ayanian JZ, Schrag D. Association of Financial Strain With Symptom Burden and Quality of Life for Patients With Lung or Colorectal Cancer. J Clin Oncol. 2016 May 20;34(15):1732–1740.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

May 20, 2016

Volume

34

Issue

15

Start / End Page

1732 / 1740

Location

United States

Related Subject Headings

  • Quality of Life
  • Patient Reported Outcome Measures
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Cost of Illness
  • Colorectal Neoplasms