Association between financial toxicity and health-related quality of life of patients with gynecologic cancer

Objectives Patients often struggle with their financial situation during cancer treatment due to treatment-related costs or loss of income. This resulting negative effect is called financial toxicity, which is a known as a side effect of cancer care. This study aimed to evaluate the association between financial toxicity and health-related quality of life among patients with gynecologic cancer using validated questionnaires. Methods In this multicenter study, patients with gynecologic cancer receiving anti-cancer drug treatment for > 2 months were recruited. Patients answered the COmprehensive Score for Financial Toxicity (COST) tool, EORTC-QLQ-C30, disease-specific tools (EORTC-QLQ-OV28/CX24/EN24), and EQ-5D-5L. Spearman’s rank correlation coefficient was used to determine associations. Results Between April 2019 and July 2021, 109 cancer patients completed the COST questionnaire. The mean COST score was 19.82. Strong associations were observed between financial difficulty ( r = − 0.616) in the EORTC-QLQ-C30 and body image ( r = 0.738) in the EORTC-QLQ-CX24, while weak associations were noted between the global health status/quality of life ( r = 0.207), EQ-5D-5L index score ( r = 0.252), and several function and symptom scale scores with the COST score. Conclusions Greater financial toxicity was associated with worse health-related quality of life scores, such as financial difficulty in gynecologic cancer patients and body image in cervical cancer patients as strong associations, and weakly associated with general health-related quality of life scores and several function/symptom scales.