B41
Associations between the financial impact of cancer and depression, anxiety and stress in individuals with breast, lung and prostate cancer
Aileen Timmons1, Linda Sharp1, Anne-Elie Carsin1, Noeleen Donnelly2, Joan Kelly2, John McCormack2, Niamh Ni Chonghaile2, Eileen O'Donnell3, Olwyn Ryan2, Harry Comber1
1National Cancer Registry Ireland, Cork, Ireland, 2Irish Cancer Society, Dublin, Ireland, 3St Vincent's Hospital, Dublin, Ireland
Background
Evidence is accumulating that cancer patients may incur additional medical and non-medical costs due to their diagnosis. They may also experience a drop in income. Little is known about the consequences of this financial burden. We investigated associations between the financial impact of cancer and adverse psychosocial states.
Method
A questionnaire was mailed to 1,373 individuals diagnosed with breast, lung or prostate cancer in the previous 18 months. Impact of cancer on household ability to make ends meet and concerns about household financial situation was assessed . Depression, anxiety and stress in the week prior to questionnaire completion were measured using the Depression Anxiety Stress Scale(DASS). Subjects were categorised as normal, mild/moderate, or severe on DASS subscales. Associations between psychosocial states and financial situation were assessed by chi-square tests.
Results
740 (54%) subjects participated. For 48% the cancer diagnosis had made it more difficulty for their household to make end meet; 44% reported no change and 8% less difficulty. Ability to make ends meet was significantly (p<0.001) associated with depression, stress and anxiety. 51% who reported more difficulty had mild/moderate/severe depression, compared to 24% reporting no change and 33% reporting less difficulty. Severe depression was three-times more frequent among those experiencing more difficulty. Prevalence of stress and anxiety was higher in those reporting more difficulty than other groups. One-third were more concerned about their household's financial situation since their cancer diagnosis; 32% were less concerned; 37% reported no change. Depression, stress and anxiety were more prevalent among those more concerned about finances than other groups (p<0.001).
Conclusion
The financial burden experienced by some cancer patients may have adverse psychosocial effects. The cross-sectional study design means the temporal relationship between cancer's financial and emotional impacts is not entirely certain. However, if replicated, our findings will have important and wide-spread implications.
