The financial impact and consequences of cancer on the lives of survivors remain poorly understood. This is especially true for colorectal cancer.
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.
This was a cross-sectional postal survey.
The study was conducted in Ireland, which has a mixed public–private healthcare system.
Colorectal cancer survivors, diagnosed 6 to 37 months prior, were identified from the population-based National Cancer Registry.
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).
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).
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.
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. See Video Abstract http://links.lww.com/DCR/A447.
1 Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
2 National Cancer Registry Ireland, Cork, Ireland
3 Beaumont Hospital, Dublin, Ireland
4 National College Ireland, Dublin, Ireland
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Funding/Support: This study was funded by a grant from the Health Research Board (SA/2004/1).
Financial Disclosure: None reported.
Correspondence: Linda Sharp, Ph.D., Institute of Health & Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle-upon-Tyne, United Kingdom. E-mail: firstname.lastname@example.org