Financial Impact of Colorectal Cancer and Its Consequences: Associations Between Cancer-Related Financial Stress and Strain and Health-Related Quality of Life

Sharp, Linda, O'Leary, Eamonn, Ó Céilleachair, Alan, Skally, Mairead and Hanly, Paul (2018) Financial Impact of Colorectal Cancer and Its Consequences: Associations Between Cancer-Related Financial Stress and Strain and Health-Related Quality of Life. Diseases of the Colon & Rectum, 61 (1). pp. 27-35. ISSN 1530-0358

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Abstract

BACKGROUND: The financial impact and consequences of cancer on the lives of survivors remain poorly understood. This is especially true for colorectal cancer.

OBJECTIVE: We investigated objective cancer-related financial stress, subjective cancer-related financial strain, and their association with health-related quality of life in colorectal cancer survivors.

DESIGN: This was a cross-sectional postal survey.

SETTINGS: The study was conducted in Ireland, which has a mixed public–private healthcare system.

PATIENTS: Colorectal cancer survivors, diagnosed 6 to 37 months prior, were identified from the population-based National Cancer Registry.

MAIN OUTCOME MEASURES: Cancer-related financial stress was assessed as impact of cancer on household ability to make ends meet and cancer-related financial strain by feelings about household financial situation since cancer diagnosis. Health-related quality of life was based on European Organisation for Research and Treatment of Cancer QLQ-C30 global health status. Logistic regression was used to identify associations between financial stress and strain and low health-related quality of life (lowest quartile, score ≤50).

RESULTS: A total of 493 survivors participated. Overall, 41% reported cancer-related financial stress and 39% cancer-related financial strain; 32% reported both financial stress and financial strain. After adjustment for sociodemographic and clinical variables, the odds of low health-related quality of life were significantly higher in those who reported cancer-related financial stress postdiagnosis compared with those who reported no change in financial stress postcancer (OR = 2.54 (95% CI, 1.62–3.99)). The odds of low health-related quality of life were also significantly higher in those with worse financial strain postdiagnosis (OR =1.73 (95% CI, 1.09–2.72)). The OR for those with both cancer-related financial stress and financial strain was 2.59 (95% CI, 1.59–4.22).

LIMITATIONS: Survey responders were younger, on average, than nonresponders. Responders and nonresponders may have differed in cancer-related financial stress and strain or health-related quality of life.

CONCLUSIONS: Four in 10 colorectal cancer survivors reported an adverse financial impact of cancer. Cancer-related financial stress and strain were significantly associated with low health-related quality of life. To inform support strategies, additional research is needed to better understand how both objective and subjective financial distress influence survivors’ health-related quality of life.

Item Type:	Article
Subjects:	R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions:	School of Business > Staff Research and Publications
Depositing User:	Caoimhe Ní Mhaicín
Date Deposited:	24 Jan 2018 12:42
Last Modified:	15 May 2018 15:36
URI:	https://norma.ncirl.ie/id/eprint/2943

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