Abstract
Introduction: Adolescent and young adult cancer survivors, especially racial/ethnic minorities and rural residents are particularly vulnerable to financial toxicity due to limited healthcare access, socioeconomic disparities, and cultural/language barriers. These social determinants of health compound financial hardship and contribute to poor healthcare transitions from pediatric to adult care, leading to worse outcomes and higher mortality rates. Methods: Our cross-sectional survey study examined racial (Black vs White) and geographic (rural vs urban) disparities in financial toxicity and healthcare transition outcomes among 260 adolescent and young adult cancer survivors through the Kentucky Cancer Registry. Survey data were collected on financial toxicity, healthcare transitions, and health-related quality of life. Financial toxicity was measured under three domains: psychological response, material conditions (e.g., loss of income, debt), and coping behaviors. Results: Results revealed moderate levels of financial toxicity and healthcare transition readiness across the sample, with strong associations between financial toxicity and anxiety, depression, and long-term effects of cancer treatment. Black participants showed higher levels of anxiety and coping behaviors compared to Whites, while urban participants experienced lower financial toxicity (as measured by material conditions) than their rural counterparts. Racial disparities were observed in global health and anxiety, even after adjusting for financial toxicity, but the relationship between financial toxicity and healthcare transitions outcomes did not vary by race or geography. Conclusion: This study highlights the importance of developing tailored strategies to mitigate the impact of cancer-related financial toxicity on the health outcomes and quality of life of underserved adolescent and young adult cancer survivors.
| Original language | English |
|---|---|
| Article number | 10732748251339251 |
| Journal | Cancer Control |
| Volume | 32 |
| DOIs | |
| State | Published - Jan 1 2025 |
Bibliographical note
Publisher Copyright:© The Author(s) 2025.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the UNITE (United in True Racial Equity) Research Priority Area and Markey Cancer Center grant mechanism at the University of Kentucky. This study was supported by the Kentucky Cancer Registry and the Patient Oriented and Population Science Shared Resource Facility, University of Kentucky Markey Cancer Center (P30CA177558); HF was supported by American Cancer Society grant No. IRG-22-152-34-IRG and American Cancer Society Center for Diversity in Cancer Research grant No. POST-BACC-22-1042000-01-DPBACC. KB was supported by the University of Kentucky’s ACTION (Appalachian Career Training in Oncology) Program (NCI R25 CA221765).
| Funders | Funder number |
|---|---|
| Kentucky Cancer Registry | |
| UNited In True Racial Equity | |
| University of Kentucky Markey Comprehensive Cancer Center | P30CA177558 |
| University of Kentucky | |
| American Cancer Society-Michigan Cancer Research Fund | IRG-22-152-34-IRG, POST-BACC-22-1042000-01-DPBACC |
| National Childhood Cancer Registry – National Cancer Institute | R25 CA221765 |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
-
SDG 3 Good Health and Well-being
Keywords
- adolescent and young adult survivors
- cancer
- financial toxicity (FT)
- healthcare transitions (HCT)
- quality of life (QOL)
ASJC Scopus subject areas
- Hematology
- Oncology
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