Abstract A098: Preliminary results of a self-reported financial toxicity survey study among rural cancer patients treated with radiotherapy
Authors: Rose Melanie , Yen Renata , Sha Sybil , Van Citters Aricca , Tosteson Anna , Meehan Kenneth , Kapadia Nirav 
Published: December 2023

Purpose/objectives: Direct and indirect expenses associated with cancer treatment can lead to finanical toxicity (FT), which is associated with reduced compliance and worse outcomes. Little is known regarding the FT experienced by cancer patients in rural areas, where added barriers impair timely accural and completion of survey data. To increase our understanding of FT experiencd by a rural population receiving radiation therapy, we piloted a validated survey of financial toxicity and report of the feasibility of recruitment, retention, and data collection.  Materials/Methods: Instituitonal approval was obtained to propsectively survey rural Northern New England radiation oncology patients served at the outreach clinic in St. Johnsbury, VT ssociated with a teritiary academic medialc center. Baseline survey was provided at time of simulation with weekly follow-up surveys provided during on-treatment visits and at regular follow-up visits up to 6 months post-completion of therapy. At baseline, respondents reported on demographics (including sex, race, education, language, insurance, employment), weekly income, expenses, travel distance, the validated COmprehensive score for financial toxicity (COST), perspectives regarding providers' understanding and empathy of finances, and summary measure of meaningful sum of weekly money to improve their financial sitution. A modified version of this survey was provided to partcipants at subsequent visits.  Results: 26 participants signed consent from 09/2022 to 01/2023 with ongoing weekly survey data collection. At baseline, patients were largely elderly (mean 68 years), mostly male (25 of 26), and white (24 of 26). Most were lower socioeconomic status, as 46% reported yearly income less than $47,000, and 50% were educated at a high-school level or less. Most patients (69%) were insured through Medicare, and three were dually enrolled in Medicaid and Medicare. The mean COST score was 12.43 (SD 11.52, range 0-44). In terms of data completion, 50% of participants (13/26) have completed questionnaires through week six of treatment, resulting in 143 completed weekly surveys. 92.6% of surveys were completed in terms of all data elements. The least responded-to prompt queried the meaninful sum of weekly money; only 81 of 143 surveys (56.6%) indicated a response, which at week 1 was $236.11 (medial; IQR $75 to $500). All other sections contained minimal data missing.  Conclusions: FT surveys of rural radiaiton oncology population with a range of educational backgrounds is feasible with high fidelity of data collection. Future steps will focus on completing follow-up of the current cohort, analyzing trends, and increasing number of observed patients to idenitfy patterns and predictors of severe FT. 

Citation Format: Melanie Rose, Renata Yen, Sybil Sha, Aricca Van Citters, Anna Tosteson, Kenneth Meehan, Nirav Kapadia. Preliminary results of a self-reported financial toxicity survey study among rural cancer patients treated with radiotherapy [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A098.