Frequency and Correlates of Financial Distress in Patients with Advanced Cancer - Journal Article

Q: What does the study define as high financial distress?

High financial distress was defined as a mean score of 4.0 on the InCharge Financial Distress/Financial Well-Being Scale (IFDFW).

Q: How common was high financial distress among patients with advanced cancer?

Among 140 adult participants, 35 patients (25%) reported high financial distress.

Q: Which patient characteristics were associated with higher financial distress?

High financial distress was associated with younger age, less likelihood of being married, lower annual household income, and decreased quality of life.

Oct 10, 2026

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Study objectives focused on quantifying how often high financial distress occurs in patients with advanced cancer and identifying clinical and demographic factors linked to such distress. High financial distress was measured using the InCharge Financial Distress/Financial Well-Being Scale (IFDFW), while quality of life was assessed via multiple validated tools. Among 140 enrolled adults, one quarter reported high financial distress, which correlated with younger age, nonmarried status, symptom burden, and reduced quality of life.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Introduction

Methods

Results

Discussion

JOURNAL OF PALLIATIVE MEDICINE Volume 00, Number 00, 2025 􀀂 Mary Ann Liebert (NY), LLC DOI: 10.1177/10966218251401403 Frequency and Correlates of Financial Distress in Patients with Advanced Cancer Jacqueline Tschanz, MD,* Rida Khan, MD,* Maxine De La Cruz, MD, Minxing Chen, and Eduardo Bruera, MD Abstract Introduction: Financial distress, a term used to encompass the negative consequences of the cost of medical treatment, can lead to delay of care, psychological distress, or even bankruptcy for patients and/or their families. Cancer is an expensive medical condition, and this distress is not routinely assessed. Methods: The primary objective of this study was to determine the frequency of high ﬁnancial distress inpatients with advanced cancer. Secondary objectives include determining the association between high ﬁnancial distress with clinical and demographic characteristics. Primary outcome was based on the result of the InCharge Financial Distress/Financial Well-Being Scale (IFDFW), an eight-question survey with each question rated from 1 (overwhelming stress) to 10 (no stress at all) . High ﬁnancial distress was deﬁned as a mean score of £4.0. Quality of life was assessed with Edmonton Symptom Assessment Scale-Financial and Spiritual Distress (ESAS-FS), Comprehensive Score for Financial Toxicity—Functional Assessment of Chronic Illness Therapy, and FACT-G surveys. Demographic data was collected from questionnaire and chart review. Results: One hundred and forty adult patients with advanced cancer were enrolled. The average patient age was in 50s, 67% were White, 12% Hispanic, 14% African American, and 4% Asian. Of the participants, 35/140 patients (25%) reported high ﬁnancial distress. Patients with high ﬁnancial distress were younger (55.1 vs. 59.3 years old,p = 0.04), less likely to be married (51.4% vs. 82.9%, p = 0.002), less likely to be working full time (23% vs. 31%, p = 0.001), and had lower annual household income (49% making less than $40,000 a year vs. 13%, p <0.001). There was a signiﬁcant association between ﬁnancial distress, symptom burden, and decreased quality of life. There was a strong correlation between the IFDFW score and single item 0–10 ﬁnancial distress ESAS (0.6,p <0.001). Discussion: High ﬁnancial distress is frequent among patients with advanced cancer. It was associated with younger age, nonmarried status, symptom severity, and decreased quality of life. Our ﬁndings suggest that ﬁnancial distress should be monitored in supportive cancer care. Keywords: ﬁnancial toxicity; ﬁnancial distress; palliative care; supportive care; advanced cancer Key Message Financial distress is frequent among patients with advanced cancer, and it was associated with younger age, nonmarried status, symptom severity, and decreased quality of life. Our ﬁndings suggest that ﬁnancial distress should be monitored in supportive cancer care. Introduction P atients and families may experience signiﬁcant distress due to the burden of cost of their cancer care, a concept called ﬁnancial distress. This can lead to delay of care, psychological distress, or even bankruptcy.1 Prior studies have shown that over half of cancer patients experience one of these three consequences, or toxicities, of the cost of care. Cancer is one of the most expensive medical conditions, second only to heart disease.2 According to recent data, treatment of cancer leads to over $16 billion in out-of-pocket costs to patients and almost $5 billion in patient time costs.3 Even with insurance, the cost of health care has been shifted to the patient, through higher premiums, deductibles, copayments, and coinsurance.4 These ﬁnancial strains can come from high out of pocket costs, decrease in income due to loss, and other Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. *Both authors contributed equally to this article as co-ﬁ

FAQs

What does the study define as high financial distress?

High financial distress was defined as a mean score of 4.0 on the InCharge Financial Distress/Financial Well-Being Scale (IFDFW).

How common was high financial distress among patients with advanced cancer?

Among 140 adult participants, 35 patients (25%) reported high financial distress.

Which patient characteristics were associated with higher financial distress?

High financial distress was associated with younger age, less likelihood of being married, lower annual household income, and decreased quality of life.

Oct 10, 2026

Upload by Melati