Association of self-reported financial burden with quality of life and oncologic outcomes in head and neck cancer

Nicholas R Lenze; Jeannette T Bensen; Laura Farnan; Siddharth Sheth; Jose P Zevallos; Wendell G Yarbrough; Adam M Zanation

doi:10.1002/hed.26934

Association of self-reported financial burden with quality of life and oncologic outcomes in head and neck cancer

Head Neck. 2022 Feb;44(2):412-419. doi: 10.1002/hed.26934. Epub 2021 Nov 18.

Authors

Nicholas R Lenze^{1

2}, Jeannette T Bensen³, Laura Farnan⁴, Siddharth Sheth⁵, Jose P Zevallos⁶, Wendell G Yarbrough^{1

4

7}, Adam M Zanation¹

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
² Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
³ Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴ Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁵ Division of Hematology and Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁶ Department of Otolaryngology - Head & Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
⁷ Department of Pathology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

PMID: 34793605
DOI: 10.1002/hed.26934

Abstract

Background: There is a paucity of data on financial toxicity among patients with head and neck squamous cell carcinoma (HNSCC).

Materials: This was a retrospective, cross-sectional study of patients with HNSCC surveyed at an outpatient oncology clinic.

Results: The sample included 202 patients with HNSCC with a mean age of 59.6 years (SD 10.0). There were 53 patients (26%) with self-reported financial burden. Education of high school or less was a significant predictor of self-reported financial burden (OR 2.52, 95% CI 1.03-6.14, p = 0.042). Patients reporting financial burden had significantly worse physical (p = 0.003), mental (p = 0.003), and functional (p = 0.036) health-related quality of life (HRQOL). Patients reporting financial burden appeared to have lower 5-year overall survival (74.3% vs. 83.9%, p = 0.165), but this association did not reach statistical significance.

Conclusion: Financial burden or toxicity may affect approximately a quarter of patients with HNSCC and appears to be associated with worse HRQOL outcomes.

Keywords: cancer survivors; cost of illness; head and neck neoplasms; health expenditures; patient-reported outcomes; quality of life.

MeSH terms

Cost of Illness
Cross-Sectional Studies
Financial Stress
Head and Neck Neoplasms* / therapy
Health Expenditures
Humans
Middle Aged
Quality of Life*
Retrospective Studies
Self Report