Examination of Longitudinal Interdependence Between Financial Toxicity and Depressive Symptoms in Black Women With Breast Cancer.

BACKGROUND

Financial toxicity, or the negative economic effect of cancer treatment, has been cross-sectionally associated with poorer psychosocial outcomes in patients with breast cancer. Few studies have examined financial toxicity longitudinally or in Black women with cancer in particular.

METHODS

Black women with non-metastatic breast cancer enrolled in this prospective study within 2 months of diagnosis. Participants completed the Comprehensive Score for Financial Toxicity (COST) and the Center for Epidemiologic Studies Depression (CES-D) at baseline, 2 months, 4 months, and 18 months. We used a random-intercept cross-lagged panel model to examine two components of the relationship between financial toxicity and depressive symptoms: the overall association (correlation of the intercepts) and the association over time. We hypothesized that financial toxicity would be associated with greater depressive symptoms (i.e., intercepts would be correlated). We further hypothesized that financial toxicity and depressive symptoms would predict each other over time (i.e., greater financial toxicity at one timepoint would be associated with greater depressive symptoms at the next timepoint, and vice versa).

RESULTS

In 107 participants, mean baseline COST score was 24.1 (SD = 9.9); mean baseline CES-D score was 15.0 (SD = 10.9). We found a strong overall association between depressive symptoms and financial toxicity (r = -0.63, p < 0.001), but the constructs did not predict each other over time.

CONCLUSIONS

Financial toxicity and depressive symptoms were strongly correlated, but we did not find prospective effects. Findings speak to the importance of longitudinal financial toxicity research in understanding patterns over time.