Financial hardship in Chinese cancer survivors

Su, Mingzhu; Lao, Jiahui; Zhang, Nan; Wang, Jialin; Anderson, Roger T.; Sun, Xiaojie; Yao, Nengliang

doi:10.1002/cncr.32943

Cited by 31 publications

(45 citation statements)

References 30 publications

(31 reference statements)

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“…(3) having willingness to participate in the survey. Those patients were excluded if they were diagnosed with multiple cancers (33). In each county or district, about 200 eligible cancer patients were randomly chosen to complete the questionnaire by face-toface interview.…”

Section: Data and Samplementioning

confidence: 99%

The Urban-Rural Disparities and Associated Factors of Health Care Utilization Among Cancer Patients in China

Wang

Hua

Yao

et al. 2022

Front. Public Health

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ObjectiveThis study aimed to examine the urban-rural disparities and associated factors of health care utilization among cancer patients in China.MethodsThis study used the data collected from a cross-sectional survey conducted in China. A total of 1,570 cancer survivors from three urban districts and five rural counties were selected by using a multistage stratified random sampling method. We measured health care utilization with the way of cancer diagnosis, the number of hospitals visited, and receiving alternative therapies. Chi-square test was used to examine the differences between urban and rural cancer patients. Binary logistic regression analysis was performed to explore the determinants of health care utilization.ResultsAmong 1,570 participants, 84.1% were diagnosed with cancer after developing symptoms, 55.6% had visited two and above hospitals, and 5.7% had received alternative therapies. Compared with urban cancer patients, rural ones were more likely to be diagnosed with cancer after developing symptoms (χ2 = 40.04, p < 0.001), while they were less likely to visit more than one hospital (χ2 = 27.14, p < 0.001). Residence area (urban/rural), health insurance type, household income, age at diagnosis, tumor site, stage of tumor, and survival years were significantly associated with health care utilization of cancer patients (p < 0.01).ConclusionsHealth care utilization was suboptimal among cancers patients in China. Rural cancer patients had less health care utilization including screenings and treatments than urban ones. Policymakers should implement specific strategies to ensure equitable utilization of cancer care. More attention should be paid to the disadvantaged groups and rural cancer patients. Prioritizing health resources allocation is needed to prevent, screen, and treat cancers in rural areas.

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Section: Data and Samplementioning

confidence: 99%

The Urban-Rural Disparities and Associated Factors of Health Care Utilization Among Cancer Patients in China

Wang

Hua

Yao

et al. 2022

Front. Public Health

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“…Coping strategies for reducing nancial toxicity Five studies described different coping strategies that cancer patients and their families adopted to meet the costs of their illness (37,(44)(45)(46)(47). These coping strategies can be described at four levels, namely: individual level; relationship level; community level; and societal level (see Figure 4).…”

Section: Health-related Quality Of Life Burdenmentioning

confidence: 99%

Financial toxicity of cancer care in low and middle-income countries: a systematic review and meta-analysis

Donkor

Atuwo-Ampoh

Yakanu

et al. 2021

Preprint

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Introduction: The costs associated with cancer diagnosis, treatment and care present enormous financial toxicity. However, evidence of financial toxicity associated with cancer in low and middle-income countries (LMICs) is scarce.Aim: To identify the extent of cancer-related financial toxicity and how it has been measured in LMICs.Methods: Four electronic databases were searched to identify studies of any design that reported financial toxicity among cancer patients in LMICs. Random-effects meta-analysis was used to derive the pooled prevalence of financial toxicity. Sub-group analyses were performed according to: costs; and determinants of financial toxicity.Results: A total of 31 studies were included in this systematic review and meta-analysis. The pooled prevalence of financial toxicity was 56.96% [95% CI, 30.51, 106.32]. In sub-group meta-analyses, the financial toxicity was higher among cancer patients with household size of more than four (1.17% [95% CI, 1.03, 1.32]; p = 0.02; I2 = 0%), multiple cycles of chemotherapy (1.94% [95% CI, 1.00, 3.75]; p = 0.05; I2 = 43%) and private health facilities (2.87% [95% CI, 1.89, 4.35]; p < 0.00001; I2 = 26%). Mean medical costs per cancer patients were $2,740.18 [95% CI, $1,953.62, $3,526.74]. The ratio of cost of care to gross domestic product (GDP) per capita varied considerably across the LMICs included in this review, which ranged from 0.06 in Vietnam to 327.65 in Ethiopia.Conclusions: This study indicates that cancer diagnosis, treatment and care impose high financial toxicity on cancer patients in LMICs. Further rigorous research on cancer-related financial toxicity is needed.

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“…Patients with brain tumours with nancial hardship and low educational quali cations usually cannot afford such treatments by themselves. In China, expenditure for diagnosis and treatment of patients with cancer seemed catastrophic and cancer-related nancial problems create barriers to seeking health care among survivors, so identifying cancer survivors who are more likely to experience nancial hardship is important [29][30].…”

Section: Predictors Of Preferring Receiving Appropriate Palliative Carementioning

confidence: 99%

Advance Directives and End-of-Life Care: Knowledge and Preferences of Patients with Brain Tumours from Anhui, China

Wang

Zhang

Hong

et al. 2020

Preprint

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Background: In Mainland China, the advance directives (ADs) and end-of-life care of patients with tumours, especially patients with brain tumours who may have lost consciousness or the ability to speak at the early stage of their illness, have been poorly acknowledged. Thus, this study aims to clarify the knowledge and preferences of the ADs and end-of-life care of patients with brain tumours and to investigate the predictors of patients’ preferences.Methods: This was a population-based cross-sectional survey that was conducted via face-to-face interviews. Information on the sociodemographic factors, brain tumour illness, knowledge and preferences of the advance decisions and end-of-life care of the patients were collected.Results: A total of 88.61% of the participants had never heard of ADs, but 65.18% would like to make ADs. Knowledge of ADs, receiving surgical treatment or radiotherapy, less than 70 years old, male, educational qualifications of college or beyond, childless, had medical insurance for nonworking or working urban residents and self-payment of medical expenses were predictors of preference for making ADs. A total of 79.43% participants would like to discuss end-of-life arrangements with medical staff, and 63.29% of participants were willing to receive end-of-life care although it could not delay death. A total of 65.82% patients with brain tumours wanted resuscitation, and as high as 45.45% of the patients thought that they did not need life support if they were in a persistent vegetative state. Brain primary tumours, ages of less than 70 years old, male, educational qualification of junior middle school or below, had children, had new rural cooperative medical insurance and had medical expenses paid by children or spouses were predictors of choosing appropriate palliative care.ConclusionsADs and end-of-life care have been poorly acknowledged amongst patients with brain tumours in mainland China. Additional efforts should be encouraged amongst patients with primary brain tumours, those are undergoing surgery and radiotherapy and those who have low socioeconomic status. A longitudinal and comprehensive study is encouraged to promote a disease-specific ADs amongst Chinese patients with brain tumours.

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Financial hardship in Chinese cancer survivors

Cited by 31 publications

References 30 publications

The Urban-Rural Disparities and Associated Factors of Health Care Utilization Among Cancer Patients in China

The Urban-Rural Disparities and Associated Factors of Health Care Utilization Among Cancer Patients in China

Financial toxicity of cancer care in low and middle-income countries: a systematic review and meta-analysis

Advance Directives and End-of-Life Care: Knowledge and Preferences of Patients with Brain Tumours from Anhui, China

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