Abstract
Background
Survivors of cancer in the United States are often financially encumbered by expenses
and lost wages from cancer treatment. The majority of patients with thyroid cancer
are diagnosed before age 65, when they are not eligible for Medicare. We hypothesized
that financial distress would be common among thyroid cancer survivors and would be
associated with poor health-related quality of life.
Methods
A financial distress questionnaire and Patient-Reported Outcomes Measurement Information
System (29-item) were completed online by 1,743 adult thyroid cancer survivors living
in the United States. Multivariable modeling was used to identify variables which
independently predicted poor health-related quality of life. The magnitude of predicted
change was estimated by β coefficients and 95% confidence intervals. A β ≥3 was considered
clinically significant; α was set at 0.01.
Results
Financial difficulties were reported by 43% of thyroid cancer survivors and were associated
with worse anxiety (β = 5.07; P < .01) and depression (β = 5.47; P < .01). Living in poverty was associated with worse anxiety (β = 4.14; P < .01) and depression (β = 4.35; P < .01). Lost productivity at work was associated with worse fatigue (β = 5.99; P < .01) and social functioning (β = –4.07; P < .01). Inability to change jobs was associated with worse fatigue (β = 3.08; P < .01), pain interference (β = 3.56; P < .01), and social functioning (β = –3.09; P < .01). Receiving disability benefits was associated with worse pain interference
(β = 3.93; P < .01). Impaired ability to obtain a job was associated with worse social functioning
(β = –3.02; P < .01). Reported unemployment rate was 12.3%.
Conclusion
Financial distress and negative financial events were common among thyroid cancer
survivors and were associated with poorer health-related quality of life across 5
Patient-Reported Outcomes Measurement Information System health domains.
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Article info
Publication history
Published online: December 19, 2019
Accepted:
November 13,
2019
Identification
Copyright
© 2019 Published by Elsevier Inc.
