Aims
To quantify the rates and magnitude of financial toxicity in cancer patients from a large regional tertiary cancer centre, and explore the impacts.
Methods
Patients presenting between April 2023 and April 2024 were invited to complete a survey including demographics, Subjective Financial Distress Questionnaire (SFDQ), and out-of-pocket costs (OOPC). Optional free-text questions allowed for further details of financial impacts, and possible solutions. Analysis of 386 responses is presented. Descriptive statistics summarised quantitative data, and free-text responses through content analysis (n=214).
Results
The majority of respondents were male (59.6%); prostate (26.2%), breast (22.8%) and head and neck (11.1%) cancer diagnoses most common; with a mean age of 67.5±12.3. 39% were currently receiving treatment. 34.2% travelled ≥100 kms for treatment, and 48.2% had some telehealth care. Of those eligible, 72.5% had accessed the patient travel subsidy scheme. 65.5% received all of their care at our centre. 51% received chemotherapy; 71.8% radiation therapy and 52.1% surgery.
31.6% reported income reduction with treatment, and 28.8% changed employment status following cancer diagnosis. 8.3% reported a SFDQ-scored rating of 3 or above, indicating financial distress, and 23.1% with a rating of 2. Median OOPC of $350 (IQR $0-$2,300) was reported.
Impacts reported included further details of income/employment changes of both patient and family members; reduction in discretionary and other spending; added mental impact of managing finances. Suggestions for possible solutions included early information and conversations and regarding finances from healthcare team, expediting support/assistance such as the travel subsidy scheme, improved financial cover for pre-diagnosis tests.
Conclusions
This study supports the growing body of evidence of financial toxicity experienced by patients receiving or following cancer treatment, highlighting inequity challenges faced by rural and remote populations. These results provide a baseline for our regional centre, underscoring areas for future improvement and research, with further analysis planned.