title: Does economic burden influence quality of life in breast cancer survivors?
abstract: OBJECTIVE
  Economic burden is emerging as a crucial dimension in our understanding of adjustment to cancer during treatment. Yet, economic burden is rarely examined in cancer survivorship. The goal of this paper is to describe the effect of economic hardship and burden among women with breast cancer.
  
  
  METHODS
  We examined baseline and follow-up (3 and 6 month) data reported by 132 stage I and II breast cancer survivors assigned to the Wait Control arm of the Breast Cancer Education Intervention (BCEI), a clinical trial of education and support interventions. Repeated measures models fitted with linear mixed models were used to examine relationships between aspects of economic burden and overall quality of life (QOL) scores. Structural equation models (SEM) were used to examine the relationship between overall economic burden and QOL.
  
  
  RESULTS
  Nineteen economic events were reported. The proportion of survivors who reported increase in insurance premiums increased in the 6-month study period (p=.022). The proportion of survivors reporting change in motivation (p=.016), productivity (p=.002), quality of work (p=.01), days missed from work (p<.001) and sacrificing other things (p=.001) declined. An increase in economic events was significantly associated with poorer quality of life at each of the study time points.
  
  
  CONCLUSIONS
  Economic burden of breast cancer extends into post-treatment survivorship. Better understanding of economic impact and managing economic burden may help maintain QOL.
authors.affiliation: School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294, USA. menesesk@uab.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Meneses
authors.forename: Andres
authors.initials: A
authors.lastname: Azuero
authors.forename: Lauren
authors.initials: L
authors.lastname: Hassey
authors.forename: Patrick
authors.initials: P
authors.lastname: McNees
authors.forename: Maria
authors.initials: M
authors.lastname: Pisu
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000191:economics* / Q000523:psychology* / Q000628:therapy; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008875:Middle Aged; D011788:Quality of Life; D012923:Social Class; D017741:Survivors / Q000523:psychology*; D014481:United States