From the Journals

Breast cancer exacts high financial toll worldwide


 

FROM JAMA NETWORK OPEN

Burden reduction

Given the high rates of financial toxicity associated with breast cancer, what strategies might reduce this cost burden?

When exploring potential factors associated with financial toxicity, the researchers found no clear association between financial toxicity and race, employment status, and age, and could draw no firm conclusions about the impact of comorbidities and urban vs. rural place of residence. In addition, cancer stage and treatments were “extremely” heterogeneous across studies and the authors found no clear association between either factor and financial toxicity.

But the authors noted that the highest-priority patients are typically those who have low education, have low socioeconomic status, lack health insurance, and live in low-resource areas.

To reduce financial toxicity and improve outcomes among patients with breast cancer, the study team recommended four potential strategies:

  • Use targeted educational campaigns to raise awareness about the signs and symptoms of breast cancer and the importance of early diagnosis and treatment.
  • Expand health care coverage to minimize direct medical out-of-pocket costs.
  • Develop programs to assist with direct nonmedical and indirect costs, such as transportation to and lodging near treatment centers and childcare.
  • Improve screening, referral, and treatment infrastructure for breast cancer care.

The researchers also noted that their data highlight the value of universal health care coverage as a policy strategy, with evidence of lower financial toxicity rates in countries with universal health coverage.

Support for the study was provided in part by the National Cancer Institute, United Nations Institute for Training and Research and the Global Surgery Foundation, Harvard Global Health Institute, Connors Center for Women’s Health and Gender Biology, the Center for Surgery and Public Health, and the National Endowment for Plastic Surgery. Dr. Ranganathan reports no relevant financial relationships. Several coauthors have disclosures; the full list can be found with the original article.

A version of this article originally appeared on Medscape.com.

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