Financial Strain Persists for Patients With Cancer Despite Support Referrals
A study conducted at an urban comprehensive cancer center highlights the ongoing burden of financial toxicity and health-related social risks among patients with cancer, even after referral for assistance. The research, published following data collection from October 2022 to December 2023, underscores the complexity of addressing economic challenges during cancer care.
Patients undergoing treatment for breast, gynecologic, gastrointestinal, or thoracic cancers were screened for financial or social hardship using the Comprehensive Score for Financial Toxicity (COST) and given a checklist for food, housing, and transportation insecurity. Of the 2196 patients who met the study inclusion criteria, 438 (20%) patients screened positive and accepted a counseling referral for support, while 246 (11%) screened positive and declined. The remaining 1512 patients (69%) screened negative.
Patients who accepted help were more likely to be younger (median age 58 years), male (82%), and from racial minority groups (31%). Although they had lower COST scores (median 10), this group had more severe financial strain and greater social risk at baseline, including higher rates of food (32%), housing (39%), and transportation (37%) insecurity.
Over a median 5.5-month follow-up period, both those who accepted and declined referrals experienced worsening financial toxicity, though the decline was slightly less among those who received support. Notably, while referrals modestly improved some previously identified social risks, patients also reported new health-related social risks at follow-up.
The findings suggest that while screening and referral systems can partially alleviate immediate needs, they may not be sufficient to prevent emerging challenges. The study calls for more robust and sustained interventions to support cancer patients facing ongoing financial and social stressors.
Reference
Chino F, Tin AL, Aviki EM, Thom B. Longitudinal outcomes after financial toxicity and health-related social risks screening and referral. Presented at: the 2024 ASCO Quality Care Symposium; September 27, 2024; Boston, MA, and virtual; Abstract 17.
