Cancer-related financial hardship among head and neck cancer survivors: risk factors and associations with health-related quality of life

dc.check.date2020-02-19
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorLu, Liya
dc.contributor.authorO'Sullivan, Eleanor
dc.contributor.authorSharp, Linda
dc.contributor.funderHealth Research Boarden
dc.date.accessioned2019-04-16T13:54:47Z
dc.date.available2019-04-16T13:54:47Z
dc.date.issued2019-02-19
dc.date.updated2019-04-16T13:45:49Z
dc.description.abstractObjective: Cancer survivors are susceptible to financial hardship. In head and neck cancer (HNC) survivors, we investigated (a) predictors for cancer‐related financial hardship and (b) associations between financial hardship and health‐related quality of life (HRQoL). Methods: We conducted a cross‐sectional study in HNC survivors identified from the National Cancer Registry Ireland. HRQoL was based on the Functional Assessment for Cancer Therapy General (FACT‐G) plus Head and Neck Module (FACT‐HN). Objective cancer‐related financial hardship (financial stress) was assessed as household ability to make ends meet due to cancer and subjective financial hardship (financial strain) as feelings about household financial situation due to cancer. Modified Poisson regression was used to identify predictors for financial hardship. Bootstrap linear regression was used to estimate associations between hardship and FACT domain scores. Results: Pre‐diagnosis retirement (relative risk [RR] 0.50, 95% confidence interval [CI] 0.37‐0.67), pre‐diagnosis financial stress (RR 1.85, 95% CI 1.58‐2.15), and treatment were significantly associated with objective financial hardship. Predictors of subjective financial hardship were similar: aged greater than or equal to 65 years, pre‐diagnosis financial stress, and treatment. Participants with objective financial hardship reported significantly lower physical (coefficient −3.45, 95% CI −4.39 to −2.44), emotional (−2.01, 95% CI −2.83 to −1.24), functional (−2.56, 95% CI −3.77 to −1.33) and HN‐specific HRQoL (−3.55, 95% CI −5.04 to −2.23). Physical, emotional, and functional HN‐specific HRQoL were also significantly lower in participants with subjective financial hardship. Conclusion: Cancer‐related financial hardship is common and associated with worse HRQoL among HNC survivors. This supports the need for services and supports to address financial concerns among HNC survivors.en
dc.description.sponsorshipHealth Research Board (Grant Number: HRA/2009/262)en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationLu, L., O'Sullivan, E. and Sharp, L. (2019) 'Cancer-related financial hardship among head and neck cancer survivors: Risk factors and associations with health-related quality of life', Psycho-Oncology, 28(4), pp. 863-871. doi: 10.1002/pon.5034en
dc.identifier.doi10.1002/pon.5034en
dc.identifier.endpage871en
dc.identifier.issn1057-9249
dc.identifier.issued4en
dc.identifier.journaltitlePsycho-Oncologyen
dc.identifier.startpage863en
dc.identifier.urihttps://hdl.handle.net/10468/7771
dc.identifier.volume28en
dc.language.isoenen
dc.publisherWileyen
dc.relation.urihttps://onlinelibrary.wiley.com/doi/abs/10.1002/pon.5034
dc.rights© 2019 John Wiley & Sons, Ltd. This is the peer reviewed version of the following article: Lu, L, O'Sullivan, E, Sharp, L. Cancer‐related financial hardship among head and neck cancer survivors: Risk factors and associations with health‐related quality of life. Psycho‐Oncology. 2019; 28: 863– 871, which has been published in final form at https://doi.org/10.1002/pon.5034. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.en
dc.subjectFinancial hardshipen
dc.subjectHead and neck canceren
dc.subjectIrelanden
dc.subjectQuality of life survivorshipen
dc.subjectCancer-related financial strainen
dc.subjectCancer-related financial stressen
dc.titleCancer-related financial hardship among head and neck cancer survivors: risk factors and associations with health-related quality of lifeen
dc.typeArticle (peer-reviewed)en
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