Longitudinal Prevalence of Financial Worry in a Cohort of Patients with Advanced Colorectal Cancer: A Secondary Observational Cohort Study.

IntroductionFinancial hardship during cancer treatment is common in privatised healthcare systems and has been extensively studied in cancer survivorship groups. The experience of financial concerns by people living with advanced, incurable cancer has been less frequently explored. This paper sought to describe the proportion of patients experiencing financial worry longitudinally, in a cohort with advanced colorectal cancer, in a publicly funded healthcare system.MethodsThis secondary analysis of a prospective, observational cohort study 'Palliative Care Early and Systematic (PaCES)' project, analysed data from 131 patients with advanced colorectal cancer, from Alberta's two tertiary cancer centres, treated between January 2018 - December 2020. Rates of self-reported financial concerns were obtained from the Canadian Problem Checklist, completed monthly for 10 months and 3 monthly thereafter.ResultsFifty-seven patients (43%) affirmed at least once that they had worried about their finances in the preceding month. Of those who reported they had "noˮ financial concerns at enrolment, 41 (35%) subsequently answered "yesˮ. The proportion of patients experiencing financial worry at any given time point fluctuated but the mean proportion was 18%. Multivariable analysis confirmed younger age (<65) was associated with more financial worry (P-value <0.01).ConclusionFinancial worry is a common and often recurrent concern for patients with advanced colorectal cancer, particularly for younger patients. Serial screening is important to detect persisting or de novo worry.