Breast cancer has worse financial impact on black women
Breast cancer took a greater financial toll on black women than white women, according to findings published in Journal of Clinical Oncology.
“With cancer care costs rising rapidly, patients often are burdened by the cost of their treatment, yet financial toxicity is rarely discussed in the clinic, and many patients and providers have little guidance about where to turn for assistance with financial burden,” Stephanie B. Wheeler, MPH, PhD, associate professor of health policy and management at University of North Carolina at Chapel Hill, and colleagues wrote. “... An understanding of the effects of financial burden among racial minorities, who shoulder a greater burden of poor cancer outcomes, is important. Black patients with breast cancer, in particular, have higher mortality and lower initiation of and adherence to guideline-recommended treatments, which may be closely related to their inability to pay for care.”
The researchers reviewed medical records and self-reported data on the financial impact of the disease among women enrolled in the Carolina Breast Cancer Study, which was purposely enriched so that about half (49%) of its participants were black and half were aged younger than 50 years (n = 2,494). Wheeler and colleagues reviewed patients’ medical records, demographics, and financial burdens at 5 months and 25 months postdiagnosis.
More than half (58%) of black women reported experiencing any adverse financial impact from cancer compared with 39% of white women (P < .001).
Models adjusted for age, stage at diagnosis and treatment found that black women were more likely to report an adverse financial impact from cancer (adjusted risk difference [aRD] = +14 percentage points; P < .001). These included income loss (aRD = +10 percentage points), health-care related financial and transportation barriers (aRD = +10 percentage points for both), job loss (aRD = +6 percentage points) and loss of health insurance (aRD = +3 percentage points; P < .001 for all).
Although the effect of race slightly lessened when the researchers adjusted for socioeconomic status, the difference remained significant for job loss, transportation barriers, income loss and overall financial impact.
“An urgent need exists for research on the financial needs of diverse patients with breast cancer, as well as for the development of interventions and support tools that identify and match patients to resources for financial assistance, can be delivered broadly across a variety [of] practice settings, and are user friendly to facilitate discussions between patients and providers about addressing financial barriers to treatment,” Wheeler and colleagues wrote. “Policies and programs that help to limit and mitigate the effects of cancer-related financial strain are needed, including ensuring greater price transparency.”
Further, the researchers added that health care providers should communicate with patients about cancer-related financial burdens, and offer cost-saving treatment options when possible.
“In the absence of such interventions, black women will continue to shoulder a disproportionate burden of cancer-related financial strain and downstream disparate cancer outcomes,” Wheeler and colleagues wrote. – by Andy Polhamus
Disclosures: Wheeler reports research funding from Pfizer. Please see the study for all other authors’ relevant financial disclosures.