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Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentations 2 - Care Equity, Quality, and Safety

Financial Toxicity Across the Thyroid Cancer Care Continuum: A Systematic Review

Monday, September 30, 2024
8:12 AM – 8:18 AM EDT
Location: MBCC, 235-237
Disclosure(s):
Maria Armache, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Nadia L. Samaha, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Madison N. Hearn, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jonathon O. Russell, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Leila J. Mady, MD, PhD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Financial toxicity (FT) refers to the financial burden experienced by patients due to costs associated with their medical care, including out-of-pocket (OOP) expenses for treatments, medications, and related costs. Patients with high financial burdens have a poorer symptom burden, quality of life, and psychological wellbeing. With the increasing prevalence of thyroid cancer (TC) worldwide, TC care is associated with increased personal and cumulative costs, potentially leading to high FT. TC survivors have been found to have one of the highest rates of bankruptcy of all studied cancer types. As FT propagates health disparities in oncology care access, quality, and clinical trial enrollment, particularly for women, younger patients, and racial/ethnic minorities, our review aims to comprehensively describe the FT associated with TC across the care continuum.

Methods: A systematic review of the literature was performed. Four databases were queried using the terms “thyroid cancer” and “financial toxicity” and their synonyms. Full-text, English studies with subjective (self-reported FT, food insecurity) and objective (OOP, unemployment) FT outcomes were included.

Results: Among 197 studies identified, 12 studies were included. Five studies addressed subjective FT, with prevalence rates ranging from 16-47%. Increased FT was associated with younger age at diagnosis, belonging to a racial minority, and having a lower annual household income. Approximately 11% of patients were found to experience food insecurity, with Hispanic ethnicity (p = 0.005) and race (p = 0.042) being significant predictors of insecurity in this patient population. When compared to other cancer types or matched controls, OOP costs and bankruptcy rates were significantly higher in patients with TC.

Conclusions: Despite a favorable prognosis, thyroid cancer patients and survivors experience significant FT. Further research is crucial to understand and mitigate the potential financial implications of TC’s different care pathways and their sequelae, and deliver a more patient-centered approach to care.

    Presenting Author(s)

  • Maria Armache, MD

    Postdoctoral research fellow
    Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University
    Baltimore, MD, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Nadia L. Samaha, BS

    Research Fellow
    Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University
    Baltimore, MD, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Madison N. Hearn, MPH

    MD candidate
    Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
    Baltimore, MD, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • KF

    Kaitlyn M. Frazier, MD

    Assistant Faculty
    Johns Hopkins University
    Baltimore, Maryland, United States

    Disclosure information not submitted.

  • DB

    Douglas Ball, MD

    Dr
    Johns Hopkins University School of Medicine, United States

    Disclosure information not submitted.

  • Jonathon O. Russell, MD

    Chief of Head and Neck Endocrine Surgery
    Russell Center for Endocrine Health
    Hunt Valley, MD, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • CF

    Carole Fakhry, MD, MPH

    Professor
    Johns Hopkins Medical Institute
    Baltimore, Maryland, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Leila J. Mady, MD, PhD, MPH

    Assistant Professor
    Johns Hopkins University
    Baltimore, MD, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.