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. 2022 Jun;18(6):e925-e937.
doi: 10.1200/OP.21.00683. Epub 2022 Feb 15.

Financial Hardship in Patients With Head and Neck Cancer

Nicole M Mott  1 , Michelle L Mierzwa  2 , Keith A Casper  3 , Jennifer L Shah  2 , Jon Mallen-St Clair  4   5 , Allen S Ho  4   5 , Zachary S Zumsteg  4   6 , Mark E P Prince  3 , Lesly A Dossett  7   8   9 , Michelle M Chen  4   5
Affiliations

Financial Hardship in Patients With Head and Neck Cancer

Nicole M Mott et al. JCO Oncol Pract. 2022 Jun.

Abstract

Purpose: Financial hardship is a growing concern for patients with cancer. Patients with head and neck cancer (HNC) are particularly vulnerable, given that a third leave the workforce following treatment. The goal of our study was to characterize financial hardship in the psychologic response (response to increased expenses) and coping behaviors (behaviors patients adopt to manage their care in the setting of increased expenses) domains in patients with HNC compared with patients with other cancers.

Methods: This was a retrospective cohort study of nationally representative public survey data from 2013 to 2018 in the National Health Interviews Survey, an annual cross-sectional household survey. We included respondents age ≥ 18 years who reported a diagnosis of cancer and identified a subset of patients with HNC. Our main outcomes were financial hardship in the psychologic response and coping behaviors domains.

Results: Our sample included a weighted population of 357,052 patients with HNC and 21.4 million patients with other cancers. Compared with patients with other cancers, patients with HNC reported greater levels of coping behaviors hardship (31% v 23%, P = .015), but similar levels of psychologic financial hardship (73% v 72%, P = .787). Medicaid or uninsured patients more often reported coping behaviors hardship. On multivariable analysis, HNC (odds ratio, 1.51; 95% CI, 1.01 to 2.24) was independently associated with coping behaviors hardship.

Conclusion: To our knowledge, this is the first study to evaluate financial hardship in patients with HNC compared with patients with other cancers that includes Medicaid and uninsured patients, who are more often to have financial hardship. Patients with HNC have greater levels of hardship in the coping behaviors domain compared with patients with other cancers, but similar levels in the psychologic response domain.

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Conflict of interest statement

Michelle L. MierzwaResearch Funding: Debiopharm Group Zachary S. ZumstegConsulting or Advisory Role: EMD Serono, Scripps Proton Therapy CenterOther Relationship: King and Spalding LLP Mark E.P. PrincePatents, Royalties, Other Intellectual Property: Receive royalties for several head and neck cancer cell lines managed by EMD Millipore Corp, US Patent US 7,723,112 B2. Compositions and Methods for Diagnosing and Treating Cancer Patents licensed to OncoMed. This is a method for sorting cancer cells to isolate cancer stem cells Lesly A. DossettResearch Funding: AHRQ Michelle M. ChenResearch Funding: NIHNo other potential conflicts of interest were reported.

Figures

FIG 1.
FIG 1.
Financial hardship in patients with HNC compared with patients with all other cancers. HNC, head and neck cancer.
See this image and copyright information in PMC

References

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