(UroToday.com) The 2022 GU ASCO Annual meeting included a prostate cancer session highlighting work from Dr. Michael Herriges and colleagues presenting results of financial toxicity and its effect on screening for prostate and colon cancer. The term ‘financial toxicity’ or ‘hardship’ is used to describe the financial problems patients experience due to high out-of-pocket costs for their healthcare. Financial toxicity in the context of cancer treatment is an area of recent study due to the significant costs associated with these treatments, but little is known about the effect of financial toxicity on cancer prevention. This study examined the effects of financial toxicity on the utilization of screening tests for prevalent cancers, including prostate and colon cancer, using a US nationally representative survey-based data source. The hypothesis was that patients with more financial hardship would show an association with decreased prevalence of prostate and colon cancer screening.
This cross-sectional survey-based US study included men and women aged 18+ from the National Health Interview Survey (NHIS) database from January – December 2018. A financial hardship score between 0 and 1 was formulated by summarizing the responses from ten financial toxicity questions including if in the past 12 months one was unable to afford prescription medication or healthcare, or if one had to skip or take less medicine to save money. A higher score was associated with a worse financial hardship score. The primary outcomes of the study were self-reported occurrence of PSA blood testing for prostate cancer screening, and occurrence of colonoscopy for colon cancer screening.
The baseline demographics among those eligible for PSA screening (received yes/no) and colonoscopy (received yes/no) are highlighted in the following table:
The mean financial hardship score for screening of prostate and colon cancer demonstrates the relationship between financial hardship and receipt of a colonoscopy or PSA screening test:
On multivariable analysis, a higher financial hardship score was associated with decreased odds for having a PSA test of 0.916 (95% CI 0.867-0.967, p=0.002) and colonoscopy of 0.969 (95% CI 0.941-0.998, p=0.039).
Dr. Herriges concluded this study assessing the impact of financial toxicity and its effect on screening for prostate and colon cancer with the following take-home messages:
- Worse financial hardship is associated with a decreased probability of having PSA or colonoscopy screening tests
- Awareness of this specific toxicity needs to be raised, examining the association of financial toxicity and screening of prostate, colon, and other additional cancers
Presented By: Michael J. Herriges, MD, The University of Toledo College of Medicine and Life Sciences, Department of Pediatrics, Toledo, OH
Co-Authors: Rachel Shenhav-Goldberg, Juliet Irene Peck, Oleg Shapiro, Joseph M Jacob, Alina Basnet, Gennady Bratslavsky, Hanan Goldberg
Affiliations: The Bob Shapell School of Social Work, Tel-Aviv University, TEL Aviv-Jaffa, Israel, Shenandoah University, Performing Arts Medicine Department, Winchester, VA, SUNY Upstate Medical University, Department of Urology, Syracuse, NY, SUNY Upstate Medical University, Department of Hematology/Oncology, Syracuse, NY
Written By: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 2022 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium, Thursday Feb 17 – Saturday Feb 19, 2022