High Financial Hardship among Patients with Advanced Ovarian Cancer

Abstract

Ovarian cancer is considered the most fatal and costly gynecologic cancer. Although personalized therapies have improved ovarian cancer prognosis, they have resulted in increased financial toxicity concerns among this population. This study evaluated financial toxicity in patients with advanced ovarian cancer. Using secondary data from a study of barriers to palliative care, financial toxicity (FT) was measured through the Comprehensive Score for Financial Toxicity scale. Univariate and bivariate analyses were used to assess the relationship between selected demographic (i.e., age, race, ethnicity, education, place of birth, insurance type, yearly household income, employment status) and treatment-specific variables (i.e., years since diagnosis, surgery, chemotherapy, radiation, hormonal and targeted therapy) with clinically relevant financial toxicity. Characteristics were compared using Fisher’s exact or chi squared tests. A total of 38 participants with advanced ovarian cancer were included in this study; 24% (n = 9) reported clinically significant FT. Income (p = .001), place of birth (p = .048) and employment status (p = .001) were related to FT. Study findings highlight that advanced ovarian cancer patients experience high FT, particularly those with low income, who are not able to work and were born outside the US. Further research using larger datasets and more representative samples is needed to inform intervention development and implementation.

Keywords:

• Employment
• financial toxicity
• income
• ovarian cancer
• target therapy

Ethics statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Helsinki declaration. This study protocol was reviewed and approved by the Institutional Review Board at the University of South Florida (Protocol #00039905). Written informed consent was obtained from all the participants in this study.

Authors contribution

Elsa María Vásquez-Trespalacios: conceptualization, formal analysis, methodology, writing original draft, and writing, review, and editing.

Jessica N. Rivera Rivera: conceptualization, formal analysis, methodology, writing original draft, and writing, review, and editing.

McKenzie McIntyre: investigation, data curation, and writing, review, and editing

Waleska Santiago-Datil: investigation, data curation, and writing, review, and editing

Robert M. Wenham: investigation, funding acquisition, and writing, review, and editing

Susan T. Vadaparampil: conceptualization, formal analysis, funding acquisition, methodology, writing original draft, and writing, review, and editing.

Andrea L. Buras: investigation, funding acquisition, and writing, review, and editing

Claire C. Conley: conceptualization, funding acquisition, and writing, review, and editing.

Data availability statement

De- identified data from this study will be made available by emailing the corresponding author as allowed by institutional IRB standards.

Additional information

Funding

Dr. Conley has received research funding from Pfizer. Dr. Wenham has participated in data safety monitoring, trial steering committee, advisory board, and speaker activities for which he has received honoraria from Tesaro/GSK, Clovis, Genentech, Mersana, Marker Therapeutics, Ovation Diagnostics, AstraZeneca, Novacure, Shattuck Labs, SeaGen, Regeneron, Legend Biotech, Sonnet Biotherapeutics, Eisai, Immunogen, Link Therapeutics, and Merck. He has received investigator grant support from Anixa Bioscience, Merck, and On Target Labs. He has stock from Ovation Diagnostics. He also receives support to the institution as a principal investigator for a number of sponsored clinical trials. This work was supported by grants from the Moffitt Cancer Center Junior Scientist Partnership Fund (PIs: Conley & Buras) and the National Cancer Institute (T32CA090314, PIs: Brandon & Vadaparampil; P30CA076292, PI: Cleveland; K08CA270402, PI: Conley).