Financial toxicity in insured cancer patients: association with global health status in a prospective Brazilian Cohort.

Authors

Natalia Cristina Cardoso Nunes, Mariana Ribeiro Monteiro, Giselle de Souza Carvalho, Juliana Pompeu Pecoraro, Thamirez de Almeida Vieira Ferreira, Paola Kelly Martins Dos Santos, Debora Cristina Victorino Azevedo, Ana Paula Victorino, Luiz Henrique de Lima Araujo

Published in

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. Volume 34. Issue 8. Jul 17, 2026. Epub Jul 17, 2026.

Abstract

Financial toxicity is increasingly recognized as a clinically relevant patient-reported outcome in oncology, yet prospective data from Latin America remain limited, particularly among privately insured populations. We evaluated the prevalence and predictors of Q28-based financial burden (FB) and financial toxicity (FT), and their association with global health status (GHS), in Brazilian cancer patients treated in the supplementary healthcare sector.
This secondary analysis pooled data from four prospective observational cohorts of patients with breast, prostate, colorectal, and lung cancer treated at Américas Oncologia (Rio de Janeiro and São Paulo, Brazil). FB was assessed using item 28 (Q28) of the EORTC QLQ-C30 at baseline and 6 months and defined as any self-reported financial difficulty (scores 2-4). FT was operationalized pragmatically as new or worsening financial difficulty at 6 months compared with baseline. GHS (items 29-30) was linearly transformed to a 0-100 scale. Logistic regression and exploratory Cox proportional hazards models were used to evaluate factors associated with FB/FT and overall survival (OS).
Among 1,343 patients, 23% reported FB at baseline and 25% at 6 months; 16% developed Q28-based FT. In multivariable models, younger age independently predicted both FB and FT, and baseline FB strongly predicted FB at 6 months (OR 5.86; 95% CI 4.31-8.01). FB and FT were independently associated with lower GHS at 6 months. FT was not independently associated with OS in multivariable analysis (adjusted HR 0.97; 95% CI 0.54-1.74), whereas higher GHS at 6 months was independently associated with improved OS.
Q28-based FB and FT are common even among privately insured cancer patients in Brazil and are associated with worse GHS. Routine screening for financial distress may help identify vulnerable patients and inform supportive care strategies, particularly for younger individuals.

PMID:
42463517
Bibliographic data and abstract were imported from PubMed on 17 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.