ASPO Abstracts
AYA Cancer Patients' and Survivors' Employment Changes during the COVID-19 Pandemic are Associated with High Financial Toxicity
Category: COVID-19 and Cancer
Conference Year: 2021
Abstract Body:
Purpose: Describe associations between adolescent and young adult (AYA) cancer patients' and survivors changes in employment during the COVID-19 pandemic and financial toxicity.
Methods: Eligible individuals were diagnosed between 15-39 years of age, currently age ≥18, and recruited through the Huntsman-Intermountain Adolescent and Young Adult Cancer Care Program (N=709). Survey questions included demographics, employment, and the 11-item COmprehensive Score for financial Toxicity (COST) which captures financial toxicity in the last four weeks. COST is scored from 0 to 44 with lower scores indicating greater financial toxicity. Scores were dichotomized as high (0-21) or low (22-44). Changes in employment since March 2020 were categorized as no change, increase in hours, and decrease in hours/lost job. We calculated descriptive statistics and fit a multivariable logistic regression to test the association between employment change and financial toxicity controlling for current age, gender, and treatment status.
Results: Of 280 respondents (39.5% participation); 198 (70.7%) were employed prior to the pandemic thus included in analyses. Employed individuals were a mean of 29.4 years (range 18-58), 64.3% were female, and 50.5% had received cancer treatment since March 2020. Nearly a third (31.3%) had lost their job or reported reduced hours; 50.3% reported high financial toxicity. Among the previously employed, those who lost their job or had their hours reduced have nearly six times the odds of high financial toxicity than those who reported no change in hours (Odds Ratio [OR]=5.8, 95% Confidence Interval [CI]: 2.6-12.9). In the same model, the odds of reporting high financial toxicity was over twice as high among females than males (OR=2.3, 95% CI: 1.2-4.5). Treatment status and age were not significant.
Conclusions: Employment changes during the COVID-19 pandemic resulted in increased financial toxicity among a population already susceptible to high financial hardship. Societal gender inequity appears to be mirrored in participants' financial toxicity during the pandemic. Employment interventions for patients and survivors of AYA cancers who have experienced job loss or reduction in work hours during the pandemic are needed and may particularly benefit females.
Keywords: Financial Toxicity, Employment, COVID-19