A Prospective Study on the Financial Impact of Breast Cancer Treatment over a 1-Year Period for Patients at a Rural Cancer Center

Abstract Background: Patients undergoing breast cancer treatment experience financial toxicity that can lead to stress and affect access to care. This study investigates the financial toxicity patients with breast cancer face. Methods: Change in level of self-reported financial toxicity was evaluated by determining the difference with the Comprehensive Score for Financial Toxicity–Functional Assessment of Chronic Illness Therapy (COST-FACIT). The survey was administered at baseline, 3, 6, and 12 months to patients undergoing treatment within a rural cancer center to understand patterns with financial toxicity. A higher score indicated less financial toxicity. Health insurance literacy data (at baseline and 1 year) and support services data (at baseline, 3, 6, and 12 months) were also collected through survey distribution. Demographic data were also collected. Results: Among 102 patients, COST-FACIT scores significantly increased over the course of the year ( P < 0.001) and combined scores were significantly higher for patients at or above the age of 65 years ( P = 0.001). There was no statistical difference between insurance type (private or public) or between the stages of breast cancer. Interrelationship analysis showed a negative correlation between COST-FACIT score and support service utilization, but not with health insurance literacy. Discussion: COST-FACIT scores were higher with treatment over time and if the patient was 65 years of age or over. Additional financial support may be beneficial to patients early on in their cancer treatment, as well as patients under the age of 65 years, although further work is needed.