Disparities in Cancer Prevention, Screening, Diagnosis and Management

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 1004

Special Issue Editor


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Guest Editor
Departments of Surgery and Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI 48201, USA
Interests: hepatocellular carcinoma; cancer surveillance; chronic liver disease; pancreatic cancer; cholangiocarcinoma; social determinants of health; healthcare disparities; health disparities

Special Issue Information

Dear Colleagues,

In this Special Issue of Cancers, we aim to highlight recent research into disparities in cancer prevention, screening, diagnosis, and management. We plan to highlight novel research into racial, ethnic, sexual orientation, and gender minorities. Additionally, we plan to highlight novel research into those impacted by the structural and social determinants of health. We are especially interested in solutions-based research which aims to overcome the challenges in the way of achieving equitable cancer care, studies evaluating the financial toxicity of cancer care, and those including patient-reported outcomes. We welcome submissions of clinical trials, interventional studies, observational studies, methodological research, reviews, and perspectives.

Dr. Eliza W. Beal
Guest Editor

Manuscript Submission Information

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Keywords

  • social determinants of health (SDOH)
  • financial toxicity
  • racial disparities
  • ethnic disparities
  • LGBTQIA+ disparities
  • cultural competency
  • cancer
  • health status disparities
  • healthcare disparities

Published Papers (1 paper)

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Research

15 pages, 785 KiB  
Article
Financial Toxicity in Swiss Cancer Patients Treated with Proton Therapy: An Observational Cross-Sectional Study on Self-Reported Outcome
by Barbara Bachtiary, Leonie Grawehr, Filippo Grillo Ruggieri, Ulrike Held and Damien C. Weber
Cancers 2023, 15(23), 5498; https://doi.org/10.3390/cancers15235498 - 21 Nov 2023
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Abstract
Background: Proton therapy is indicated for cancers that would be difficult to treat with conventional radiotherapy. Compulsory healthcare insurance covers the costs of this therapy in Switzerland, but this does not mean that proton therapy is cost-neutral for every cancer patient. Significant out-of-pocket [...] Read more.
Background: Proton therapy is indicated for cancers that would be difficult to treat with conventional radiotherapy. Compulsory healthcare insurance covers the costs of this therapy in Switzerland, but this does not mean that proton therapy is cost-neutral for every cancer patient. Significant out-of-pocket (OOP) costs may arise due to expenses associated with proton therapy, and patients may experience treatment-related financial distress—an effect known as “financial toxicity.” This study investigates the financial toxicity of patients undergoing proton therapy in a high-income country with a compulsory health insurance policy. Methods: Between September 2019 and November 2021, 146 Swiss cancer patients treated with proton therapy participated in this study, of whom 90 (62%) were adults and 56 (38%) were caregivers of child cancer patients. Financial toxicity was assessed using the FACIT Comprehensive Score for Financial Toxicity (COST). OOP costs during proton therapy were recorded weekly, and financial coping strategies were captured at the end of treatment. Findings: The median COST score, indicating financial toxicity, was 29.9 (IQR 21.0; 36.0) for all patients, 30.0 (IQR 21.3; 37.9) for adults, and 28.0 (IQR 20.5; 34.0) for children’s caregivers. Higher income (estimate 8.1, 95% CI 3.7 to 12.4, p ≤ 0.001) was significantly associated with higher COST scores, indicating less financial toxicity. Further distance from home to the treatment centre per 100 km (estimate −3.7, 95% CI −5.7 to −1.9, p ≤ 0.001) was significantly associated with lower COST scores, indicating increased financial toxicity. Married adult patients had substantially lower COST scores than single patients (estimate: −9.1, 95% CI −14.8 to −3.4, p ≤ 0.001). The median OOP cost was 2050 Swiss francs (CHF) and was spent mainly on travel, accommodation, and eating out. Sixty-three (43%) patients used their savings; 54 (37%) cut spending on leisure activities; 21 (14.4%) cut living expenses; 14 (9.6%) borrowed money; nine (6.2%) worked more; and four (2.7%) sold property. Patients with high COST scores used significantly fewer coping strategies such as saving on leisure activities (estimate −9.5, 95% CI −12.4 to −6.6, p ≤ 0.001), spending savings (estimate −3.9, 95% CI −6.3 to −1.4, p = 0.002), borrowing money (estimate −6.3, 95% CI −10.4 to −2.2, p = 0.003), and increasing workload (estimate −5.5, 95% CI −10.5 to −0.4, p = 0.035). Interpretation: A substantial number of cancer patients treated with proton therapy experience financial toxicity in Switzerland. Long travel distances to the proton therapy centre and low income negatively affect the financial well-being of these patients during proton therapy. Full article
(This article belongs to the Special Issue Disparities in Cancer Prevention, Screening, Diagnosis and Management)
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