2821 - Financial Toxicity among Long Term Survivors of Prostate Cancer

K. Kane¹, A. Katz², Y. Cao¹, R. D. Mali¹, D. Usinger³, R. C. Chen¹, and X. Shen¹; ¹Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS, ²Department of Population Health, University of Kansas Medical Center, Kansas City, KS, ³University of North Carolina at Chapel Hill, Chapel Hill, NC

Purpose/Objective(s): Financial toxicity is commonly reported among cancer survivors, however factors contributing to long term financial toxicity have not been well studied. The goal of this analysis is to evaluate the association between predictive factors and patient reported financial toxicity in patients with prostate cancer. Materials/

Methods: The North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study is a population-based cohort of newly-diagnosed prostate cancer patients enrolled in collaboration with the state cancer registry throughout North Carolina from 2011-2013, and followed prospectively. Financial toxicity (FT) was assessed using five questions taken from the National Health Interview Survey on inability to pay for medical costs and forgoing medical care due to cost at 108 months of follow-up. A participant is deemed to have FT if they reported yes to any one of the five FT questions. Patient characteristics, cancer stage, initial treatment and recurrence data were collected. Logistic regression was used to assess factors associated with FT.
Results: A total of 361 participants completed the financial toxicity questionnaire and form the analytic cohort. The cohort is socio-demographically diverse with 24% Black race, 25% living in rural areas, and 55% with a high school education or less. Overall, 22% reported having financial toxicity. On multivariable analysis, Black race was associated with financial toxicity (OR 3.56 vs White, p<.001); age, education, household income, marital status, urban/rural residence, prostate cancer risk group, initial treatment, and disease recurrence were not.
Conclusion: A large minority (22%) of long-term prostate cancer survivors reported financial toxicity. There was a higher rate in Black vs White survivors. These data highlight the importance of continuing to address this issue not only in newly-diagnosed cancer patients, but in long-term survivors also.

Abstract 2821 – Table 1: Multivariable logistic regression analysis of factors associated with financial toxicity

	Odds Ratio (95% CI)	p value
Age (REF: < 63 years) = 63 years	0.93 (0.50-1.74)	0.824
Race (REF: White) Black Other	3.56 (1.86-6.81) 0.61 (0.07-5.53)	<0.001
Education (REF: High School or Less) College	1.01 (0.50-2.03)	0.988
Income (REF: =90,000) <$40,000 $40,000-90,0000	2.48 (0.84-7.35) 2.20 (0.83-5.82)	0.231
Marital Status (REF: Married) Not Married or with partner	0.43 (0.70-2.92)	0.328
Residence (REF: Urban) Rural	0.92 (0.48-1.78)	0.811
Risk Group (REF: High) Low Intermediate	0.83 (0.36-1.92) 0.91 (0.38-2.19)	0.906
Initial Treatment (REF: Active Surveillance) Radiation/Brachytherapy Surgery	1.26 (0.59-2.70) 0.74 (0.34-1.58)	0.390
PSA Recurrence or Salvage Treatment (REF: No Recurrence) Recurrence or Salvage Treatment	1.74 (0.76-3.97)	0.187