title: Impact of financial burden of cancer on survivors' quality of life.
abstract: OBJECTIVE
  Little is known about the relationship between the financial burden of cancer and the physical and emotional health of cancer survivors. We examined the association between financial problems caused by cancer and reported quality of life in a population-based sample of patients with cancer.
  
  
  METHODS
  Data from the 2010 National Health Interview Survey (NHIS) were analyzed. A multivariable regression model was used to examine the relationship between the degree to which cancer caused financial problems and the patients' reported quality of life.
  
  
  RESULTS
  Of 2,108 patients who answered the survey question, "To what degree has cancer caused financial problems for you and your family?," 8.6% reported "a lot," whereas 69.6% reported "not at all." Patients who reported "a lot" of financial problems as a result of cancer care costs were more likely to rate their physical health (18.6% v 4.3%, P < .001), mental health (8.3% v 1.8%, P < .001), and satisfaction with social activities and relationships (11.8% v 3.6%, P < .001) as poor compared to those with no financial hardship. On multivariable analysis controlling for all of the significant covariates on bivariate analysis, the degree to which cancer caused financial problems was the strongest independent predictor of quality of life. Patients who reported that cancer caused "a lot" of financial problems were four times less likely to rate their quality of life as "excellent," "very good," or "good" (odds ratio = 0.24; 95% CI, 0.14 to 0.40; P < .001).
  
  
  CONCLUSIONS
  Increased financial burden asa result of cancer care costs is the strongest independent predictor of poor quality of life among cancer survivors.
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Fenn
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Suzanne B
authors.initials: SB
authors.lastname: Evans
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Michael P
authors.initials: MP
authors.lastname: DiGiovanna
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Lajos
authors.initials: L
authors.lastname: Pusztai
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Tara
authors.initials: T
authors.lastname: Sanft
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Erin W
authors.initials: EW
authors.lastname: Hofstatter
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Brigid K
authors.initials: BK
authors.lastname: Killelea
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: M Tish
authors.initials: MT
authors.lastname: Knobf
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Lannin
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Maysa
authors.initials: M
authors.lastname: Abu-Khalaf
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT.
authors.forename: Nina R
authors.initials: NR
authors.lastname: Horowitz
authors.affiliation: Yale School of Medicine; and Yale School of Nursing, New Haven, CT anees.chagpar@yale.edu.
authors.forename: Anees B
authors.initials: AB
authors.lastname: Chagpar
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use; D017281:Cost of Illness; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000191:economics* / Q000523:psychology*; D011788:Quality of Life; D012044:Regression Analysis; D017741:Survivors; D014481:United States
chemical_list: D000970:Antineoplastic Agents