Abstract A100: Addressing financial toxicity and associated social determinants among Hispanic cancer patients in Puerto Rico
Authors: Soto-Salgado Marievelisse , Contreras-Fernández Sofía , González-Sepúlveda Lorena , Torres-Mojica Karina , Avilés-Mercado Rocío , González-Mayoral Juan Paulo , Cardona-Cordero Nancy 
Published: September 2024

Abstract
Introduction: Cancer is one of the most expensive medical conditions to treat due to the cost and duration of treatment. Financial toxicity (FT) describes the problems that a cancer patient has related to the cost of medical care, including subjective financial concerns. Despite the high burden of cancer, significant levels of poverty, and a fragile healthcare system in Puerto Rico (PR), no previous studies have evaluated FT among cancer patients in PR. Thus, we aimed to assess FT and associated social determinants among Hispanic cancer patients in PR. Methods: We are conducting a cross-sectional study through an online survey among cancer patients aged 21+ years who have received active cancer treatment over the last year. We use the COST-FACIT questionnaire, a validated survey composed of 12 questions; to measure low (score ≥ 21) and high (score &lt; 21) FT. We also collect information on social determinants, including demographics, clinical characteristics, access to healthcare services, quality of life, social support, and patient navigation services, among others. Cronbach's alpha was used to assess the internal consistency of the FT score. Univariate (ULRM) and multivariate logistic regression models (MLRM) were used to determine the social determinants associated with FT. MLRM included significant variables in the ULRM (p &lt; 0.10) and predictors supported by scientific literature. Results: As of April 8th, 2024, 387 people accessed the survey, with 294 (80.0%) completing it, including the FT section. The final sample size for this preliminary data analysis included 226 participants due to the exclusion of missing information on important covariates. Most of the participants were 51 to 64 years of age (46.9%), female (72.6%), had annual income &lt; $25,000 (59.7%), and had a bachelor’s degree or higher (51.8%). COST-FACIT demonstrated good internal consistency (alpha=0.83). Approximately 46.0% of the participants had a high FT (overall FT mean score = 21.0±8.9). MLRM show that retired participants (OR: 0.22, 95%CI: 0.22-0.59) had less odds of high FT, while those who have public health insurance (OR: 2.38, 95%CI: 1.02-5.54), have comorbidities (OR: 2.27, 95%CI: 1.08-4.79), and have had a cancer diagnosis for more than 1 year (OR: 1.90, 95%CI: 1.02-3.53) have significantly higher odds of experiencing high FT. Conclusion: FT is higher among cancer patients with public health insurance, comorbidities, and more than one year since cancer diagnosis, but FT is lower in retired cancer patients. More research is needed to identify and evaluate interventions to address the FT of cancer treatment and the social determinants associated among Hispanic/Latino patients. IRB: This project was approved by the Institutional Review Board of the University of Puerto Rico Comprehensive Cancer Center (IRB # 2023-11-123).
Citation Format: Marievelisse Soto-Salgado, Sofía Contreras-Fernández, Lorena González-Sepúlveda, Karina Torres-Mojica, Rocío Avilés-Mercado, Juan Paulo González-Mayoral, Nancy Cardona-Cordero. Addressing financial toxicity and associated social determinants among Hispanic cancer patients in Puerto Rico [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A100.