Trajectories and predictors of financial toxicity in breast cancer patients: A multicenter longitudinal study in China
Background: Patients with breast cancer experience varying levels of financial toxicity (FT), but the factors contributing to sustained financial toxicity remain poorly understood. Methods: This longitudinal study was conducted from November 2022 to March 2024 in China. Participants were recruited f...
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Elsevier
2025-06-01
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| Series: | Breast |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977625004588 |
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| author | Yi Kuang Jiajia Qiu Ye Liu Sijin Guo Ting Chen Lichen Tang Winnie K.W. So Weijie Xing |
| author_facet | Yi Kuang Jiajia Qiu Ye Liu Sijin Guo Ting Chen Lichen Tang Winnie K.W. So Weijie Xing |
| author_sort | Yi Kuang |
| collection | DOAJ |
| description | Background: Patients with breast cancer experience varying levels of financial toxicity (FT), but the factors contributing to sustained financial toxicity remain poorly understood. Methods: This longitudinal study was conducted from November 2022 to March 2024 in China. Participants were recruited from four Tertiary Level A hospitals using convenient sampling. FT was assessed using the Comprehensive Score for Financial Toxicity (COST) at baseline (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-surgery. Growth Mixture Modeling was used to identify the different trajectories of the FT. Multivariable logistic regression were employed to explore the predictive factors with different trajectory categories. Results: Among 378 participants (all women; median [SD] age, 48.9 [9.97] years), the COST score was lowest at T2. Three distinct FT trajectories were identified: 91 patients (24 %) in the ''Severe FT with Gradual Relief'' group (trajectory 1), 190 patients (50 %) in the ''Persistently Low-Level FT'' group (trajectory 2), and 97 patients (26 %) in the ''Moderate FT with Gradual Worsening'' group (trajectory 3). Using trajectory 2 as the reference, predictors for trajectory 1 included symptom burden, location, cancer stage, cost-related health literacy, resilience, and difficulty affording basic expenses. For trajectory 3, predictors included monthly household income, symptom burden, location, and cancer stage. Conclusions: The FT experienced by breast cancer patients changes over time and follows distinct dynamic trajectories, influenced by multiple factors. In future clinical practice, early identification and intervention for high-risk FT groups should be prioritized. |
| format | Article |
| id | doaj-art-5c34c43997c64d2bbaffdb1e3929e370 |
| institution | OA Journals |
| issn | 1532-3080 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj-art-5c34c43997c64d2bbaffdb1e3929e3702025-08-20T02:30:55ZengElsevierBreast1532-30802025-06-018110444110.1016/j.breast.2025.104441Trajectories and predictors of financial toxicity in breast cancer patients: A multicenter longitudinal study in ChinaYi Kuang0Jiajia Qiu1Ye Liu2Sijin Guo3Ting Chen4Lichen Tang5Winnie K.W. So6Weijie Xing7School of Nursing Fudan University, Shanghai, China; The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaFudan University Shanghai Cancer Center, Shanghai, ChinaThe First Hospital of China Medical University, Shenyang, ChinaXijing Hospital, The Air Force Medical University, Xi'an, ChinaUnion Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaFudan University Shanghai Cancer Center, Shanghai, ChinaThe Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of ChinaSchool of Nursing Fudan University, Shanghai, China; Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China; Corresponding author. School of Nursing, Fudan University, Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, 305 Fenglin Rd, Shanghai, 200032, China.Background: Patients with breast cancer experience varying levels of financial toxicity (FT), but the factors contributing to sustained financial toxicity remain poorly understood. Methods: This longitudinal study was conducted from November 2022 to March 2024 in China. Participants were recruited from four Tertiary Level A hospitals using convenient sampling. FT was assessed using the Comprehensive Score for Financial Toxicity (COST) at baseline (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-surgery. Growth Mixture Modeling was used to identify the different trajectories of the FT. Multivariable logistic regression were employed to explore the predictive factors with different trajectory categories. Results: Among 378 participants (all women; median [SD] age, 48.9 [9.97] years), the COST score was lowest at T2. Three distinct FT trajectories were identified: 91 patients (24 %) in the ''Severe FT with Gradual Relief'' group (trajectory 1), 190 patients (50 %) in the ''Persistently Low-Level FT'' group (trajectory 2), and 97 patients (26 %) in the ''Moderate FT with Gradual Worsening'' group (trajectory 3). Using trajectory 2 as the reference, predictors for trajectory 1 included symptom burden, location, cancer stage, cost-related health literacy, resilience, and difficulty affording basic expenses. For trajectory 3, predictors included monthly household income, symptom burden, location, and cancer stage. Conclusions: The FT experienced by breast cancer patients changes over time and follows distinct dynamic trajectories, influenced by multiple factors. In future clinical practice, early identification and intervention for high-risk FT groups should be prioritized.http://www.sciencedirect.com/science/article/pii/S0960977625004588Financial toxicityTrajectoryPredictive factorsGrowth mixture modelingLongitudinal studyBreast cancer |
| spellingShingle | Yi Kuang Jiajia Qiu Ye Liu Sijin Guo Ting Chen Lichen Tang Winnie K.W. So Weijie Xing Trajectories and predictors of financial toxicity in breast cancer patients: A multicenter longitudinal study in China Breast Financial toxicity Trajectory Predictive factors Growth mixture modeling Longitudinal study Breast cancer |
| title | Trajectories and predictors of financial toxicity in breast cancer patients: A multicenter longitudinal study in China |
| title_full | Trajectories and predictors of financial toxicity in breast cancer patients: A multicenter longitudinal study in China |
| title_fullStr | Trajectories and predictors of financial toxicity in breast cancer patients: A multicenter longitudinal study in China |
| title_full_unstemmed | Trajectories and predictors of financial toxicity in breast cancer patients: A multicenter longitudinal study in China |
| title_short | Trajectories and predictors of financial toxicity in breast cancer patients: A multicenter longitudinal study in China |
| title_sort | trajectories and predictors of financial toxicity in breast cancer patients a multicenter longitudinal study in china |
| topic | Financial toxicity Trajectory Predictive factors Growth mixture modeling Longitudinal study Breast cancer |
| url | http://www.sciencedirect.com/science/article/pii/S0960977625004588 |
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