Introduction

Costly cancer surveillance and treatment can lead to financial toxicity (FT), an adverse financial condition as a consequence of the treatment of a disease. Evidence suggests that FT is associated with worse mortality, which may be related to impaired health-related quality of life (HRQOL). The purpose of this study is to evaluate the association of FT with HRQOL among patients with bladder cancer.

Methods

Bladder cancer patients were identified from the University of North Carolina Health Registry/Cancer Survivorship Cohort (HR/CSC), which includes patient-reported data on FT and QOL. FT was defined as agreement with the following statement “you have to pay more for medical care than you can afford.� Cancer-specific and general HRQOL was measured using the validated FACT-G, FACT-Bl and PROMIS questionnaires. Bivariate analyses were performed comparing FT and HRQOL scores using Student’s t-test.

Results

144 bladder cancer patients were enrolled in HR/CSC, of which 138 completed the baseline questionnaire. Median age was 66.9 years. 75% were male, 89% were white, and 66% had less than a college degree. Half of patients had a stage of cT2 or higher. Thirty-three participants overall (24%) endorsed FT. With regard to general HRQOL using the PROMIS questionnaire, patients with FT had worse physical and mental health scores compared to those without FT (p=0.03 and <0.01, respectively). Patients who endorsed FT also reported lower cancer-specific QOL (72 vs. 81) as well as physical well-being (20.3 vs. 23.0) (p=0.01). Patients who endorsed FT reported lower functional well-being (14.6 vs. 17.8; p=0.05). No differences in social well-being, emotional well-being or bladder-cancer specific QOL were noted.

Conclusions

FT is negatively associated with physical and mental health-related quality of life among bladder cancer patients. Our future research will investigate the association between FT and HRQOL as affected by patient-specific characteristics such as demographics, disease stage, and comorbidities.

Funding

none