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Self-reported financial difficulties of colorectal cancer patients 1 year after start of treatment

Background - The purpose of this study is to investigate self-reported financial difficulties (FDs) in patients with colorectal cancer (CRC) and to develop easy-to-implement models to predict FDs 1 year after initiation of CRC treatment. - Materials and methods - In the prospective EDIUM cohort, CRC...

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Main Authors: Sibert, Nora Tabea (Author) , Breidenbach, C. (Author) , Benz, S. R. (Author) , Post, Stefan (Author) , Seufferlein, T. (Author) , Ackermann, C. (Author) , Blossey, R. D. (Author) , Böhm, G. (Author) , Brennfleck, F. (Author) , Bunse, J. (Author) , Dahlke, M. -H. (Author) , Egetemeyer, J. (Author) , Elhabash, S. (Author) , Emmanouilidis, N. (Author) , Flemming, S. (Author) , Freitag, B. (Author) , Goetzky, K. (Author) , von Haeften, E. (Author) , Henschel, M. (Author) , Hollerbach, S. (Author) , Höppner, J. (Author) , Kim, M. (Author) , Klein, C. (Author) , Klinik, C. (Author) , Klump, B. (Author) , Köninger, J. (Author) , Lee, L. D. -G. (Author) , Mirow, L. (Author) , Ockenga, J. (Author) , Petzoldt, S. (Author) , Neumann, P. A. (Author) , Piso, P. (Author) , Reißfelder, Christoph (Author) , Rickenberger, A. (Author) , Riechmann, M. (Author) , Rolinger, J. (Author) , Rosenberg, R. (Author) , Schilawa, D. (Author) , Schmidt, J. (Author) , Schnell, M. W. (Author) , Steinemann, D. (Author) , Varga-Szabó, D. (Author) , Wahba, R. (Author) , Weyhe, D. (Author) , Willeke, F. (Author) , Wirth, U. (Author) , Wittel, U. (Author) , Zielinski, C. B. (Author) , Kolb, V. (Author) , Kowalski, C. (Author)
Format: Article (Journal)
Language:English
Published: May 2025
In: ESMO open
Year: 2025, Volume: 10, Issue: 5, Pages: 1-9
ISSN:2059-7029
DOI:10.1016/j.esmoop.2025.105078
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.esmoop.2025.105078
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2059702925009470
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Author Notes:N.T. Sibert, C. Breidenbach, S.R. Benz, S. Post, T. Seufferlein, C. Ackermann, R.D. Blossey, G. Böhm, F. Brennfleck, J. Bunse, M.-H. Dahlke, J. Egetemeyer, S. Elhabash, N. Emmanouilidis, S. Flemming, B. Freitag, K. Goetzky, E. von Haeften, M. Henschel, S. Hollerbach, J. Höppner, M. Kim, C. Klein, C. Klinik, B. Klump, J. Köninger, L. D.-G. Lee, L. Mirow, J. Ockenga, S. Petzoldt, P.A. Neumann, P. Piso, C. Reißfelder, A. Rickenberger, M. Riechmann, J. Rolinger, R. Rosenberg, D. Schilawa, J. Schmidt, M.W. Schnell, D. Steinemann, D. Varga-Szabó, R. Wahba, D. Weyhe, F. Willeke, U. Wirth, U. Wittel, C.B. Zielinski, V. Kolb & C. Kowalski
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Summary:Background - The purpose of this study is to investigate self-reported financial difficulties (FDs) in patients with colorectal cancer (CRC) and to develop easy-to-implement models to predict FDs 1 year after initiation of CRC treatment. - Materials and methods - In the prospective EDIUM cohort, CRC patients are asked to complete the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and QLQ-CR29 before (T0) and 1 year after initiation of treatment (T1). These patient-reported outcomes are combined with sociodemographic and clinical data. The QLQ-C30 ‘FD’ item is firstly analysed descriptively, together with covariates. Logistic lasso regression was carried out to develop a predictive model (full model) of FDs at T1, and its predictive capacity was assessed. This predictive model was then simplified using easy-to-collect predictors which showed importance in the full model. - Results - Of 9124 CRC patients enrolled between October 2018 and May 2023, 6061 completed follow-up questionnaires (T1). Of those initially without FDs (n = 4989), 25% (1248 patients) reported new FDs at T1. These patients were younger [median age 66 versus 72 years; odds ratio (OR) 2.81 (95% confidence interval [CI] 2.46-3.22)] and had a higher proportion of lower educational attainment [74% versus 69%; OR 1.32 (95% CI 1.14-1.54)]. Clinically, FDs were more frequently reported by patients with higher International Union Against Cancer (UICC) stages [48% in stages III/IV versus 32.5% in stages I/II; OR 1.98 (95% CI 1.74-2.26)] and rectal cancer [37% versus 28%; OR 1.52 (95% CI 1.32-1.73)]. The full model [based on a test and training dataset of n = 5910 patients, including 14 predictors, area under the curve (AUC) 0.75] was reduced to two simplified models with only the predictors age, sex (model 1, AUC 0.72)/localisation of tumour (model 2), and FDs at T0 (AUC = 0.74). On this basis, two risk assessment tables were developed. - Conclusions - A significant proportion of CRC patients report FDs 1 year after treatment initiation, particularly among socioeconomically disadvantaged groups. Together with the predictive models and two ready-to-use risk assessment tables, these findings can be utilised by clinicians and psychosocial counselling services to provide tailored support options.
Item Description:Online verfügbar: 2. Mai 2025, Artikelversion: 2. Mai 2025
Gesehen am 26.05.2025
Physical Description:Online Resource
ISSN:2059-7029
DOI:10.1016/j.esmoop.2025.105078

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