Abstract B071: Differences in financial toxicity (FT) by cancer type among patients assigned female at birth (AFAB)
Authors: Orozco Cristina , Gutter Michael 
Published: January 2023

Abstract
Cancer is a major financial burden across its different forms at varying stages, and oftentimes even more so for patients assigned female at birth (AFAB) within Black and Brown communities. Unfortunately, medical treatment has been increasingly costly, heightening financial need. Financial toxicity (FT) refers to issues associated with cancer’s cost of medical care (NIH, 2021). The current study was a secondary analysis with data acquired from 2018 Gutter and Salloum Catchment Area Study. It used the COmprehensive Score for FT (COST) questionnaire scores to measure FT (De Souza, et al.). The study examined how COST scores vary based on race, income, caregiver presence, and cancer type with a random sample size of n= 191. The study included the following cancers: leukemia, lung, breast, cervical, and gynecological. SPSS was used to examine data via ANOVA and ordinary least squares regression. For COST scores, the smaller the score, the more FT. Breast cancer had higher predicted COST score compared to other cancers as further confirmed by the ordinary least squares regression; furthermore, breast cancer was found to have lower expenses. Perhaps breast cancer’s ubiquity has led to more funding in support groups and more efforts in preventative measures. Upcoming outreach projects should increase support for other cancer types in patients AFAB, particularly those of color, and work to uphold efforts for all breast cancer patients. The ANOVA suggested there is a significant difference in mean COST score by cancer type as F=4.955 with a significance level of 0.001. This suggests that mean COST scores are related to cancer type. Moreover, as a product of SDH, it has been known that Black and Brown communities experience worsened health outcomes regardless of cancer diagnosis; unfortunately, sex and gender (and sexuality) as intersecting identities within this often exacerbate these outcomes since some patients AFAB may choose to identify with a different gender. Further, Black, and Hispanic patients AFAB are disproportionately affected by cancer (and many times more aggressive types of cancers). These striking disparities make it that much more vital that clinicians consider certain cancers carry more FT when delivering care. This work has applications for clinical practice settings in that clinicians must offer patient-centered, financially considerate care in hopes of improving health outcomes. Lastly, income, race, and presence of caregiver were not significantly related to FT, which refutes existing scholarship in conversation with determinants of health. I believe this is due to a sample that over-represented white people. Therefore, upcoming cancer research must be situated around the minority experience to gauge the nuances of FT both quantitively and qualitatively in different cancers, particularly given the paucity of qualitative work in cancer research. Researchers must not just represent minority voices and experiences, but they must consider differences among minority groups historically, culturally, geographically, etc.
Citation Format: Cristina Orozco, Michael Gutter. Differences in financial toxicity (FT) by cancer type among patients assigned female at birth (AFAB) [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B071.