Introduction Ongoing effects of cancer-related financial distress (CRFD) are not well described. We explored the correlation between CRFD and patient-reported outcomes (PROs) in a longitudinal study of individuals with recurrent ovarian cancer (ROC).

Methods Participants with ROC completed validated PRO instruments at enrollment and every 3 months thereafter for ≤4 years. Instruments included FACIT-COST (financial distress among people with cancer), MDASI-O (symptom burden), FACT-O (quality of life), CESD-20 (depression), GAD-7 (anxiety), EQ-5D-5L (well-being), and Mini-IPIP (personality). Correlation between FACIT-COST and other PRO was assessed using Spearman correlation (rho).

Results Table 1 highlights demographics (N=268; 1974 observations). Table 2 shows correlation between FACIT-COST and other PROs. There were weak positive correlations between the FACIT-COST and the FACT-O subscales and EQ-5D-5L VAS (0.17<rho≤0.33, p<0.001), and weak negative correlation with GAD-7, CESD-20, Mini-IPIP Neuroticism, MDASI Symptom Severity, MDASI Symptom Distress, and MDASI-OC (-0.34≤rho≤-0.27, p<0.001). FACIT-COST had the strongest correlation with anxiety and depression (rho=-0.34, p<.001), neuroticism (rho=-0.34, p<.001), and symptom severity (rho=-0.32, p<.001). Patients with annual household income > $75K had a stronger positive correlation than those with ≤ $75K for social well-being (rho=0.33 and 0.20, <0.001). Lower financial distress was associated with lower anxiety and depression, lower symptom burden, and better overall well-being (p<.01 for all).

Conclusion/Implications Patients with lower CRFD were more likely to report lower levels of anxiety, depression, and symptom burden, and higher levels of physical, social, emotional, and functional well-being. Efforts to ameliorate financial toxicity may yield a high return on investment with more sweeping implications on mental, emotional and physical wellbeing.