Financial Toxicity in Cervical Cancer Patients Undergoing Radical Treatment With External Beam Radiation and Brachytherapy at a Tertiary New Zealand Radiation Oncology Centre

INTRODUCTION: Financial toxicity refers to the objective financial burden and subjective financial distress caused by medical treatment. Cervical cancer patients experience high financial toxicity internationally, and local evidence suggests similar challenges in New Zealand. This study aimed to measure the prevalence and severity of financial toxicity in patients undergoing radiation treatment for cervical cancer at Wellington Blood and Cancer Centre (WBCC). METHODS: Twelve patients undergoing cervical cancer treatment and 29 patients receiving curative radiation therapy completed surveys including demographics, COST-FACIT measure of financial toxicity and quality of life (EORTC QLQ-C30) at treatment commencement and again at treatment completion. Group comparisons were analysed using repeated measures ANOVA. RESULTS: Cervical cancer patients (n = 10) reported significantly greater financial toxicity than comparison patients (n = 27), with lower COST-FACIT Scores (20.6 vs. 29.7), p = 2. Younger age, greater distance from WBCC and cervical cancer treatment group were independently associated with increased financial toxicity. Global Health Scores, Financial Difficulty Score, Social Functioning Score and symptoms were significantly worse in the cervical cancer group. Eight out of ten participants (80%) From the cervical cancer group met criteria for financial toxicity based on COST-FACIT Score. Median out of pocket costs and income-related loss were $1814NZD (IQR $1041-$2182) for cervical cancer patients, compared to $264NZD (IQR $71-$558 p = 0.006, Mann-Whitney U Test) for others. CONCLUSION: Patients receiving radiation for cervical cancer experience significantly higher financial toxicity than other WBCC patients. Addressing the financial burden of treatment should be a priority in support for this vulnerable group.