Assessment of Individual and Familial Financial Toxicity Using the Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT)

Objectives: Hispanic-American populations face a high and growing burden of cancer and health disparities. Financial toxicity (FT) describes the economic distress experienced by cancer patients during diagnosis/treatment; familial financial toxicity (FFT) describes the financial distress experienced by families adapting to the economic challenges of cancer. This study assesses FT/FFT among Hispanic-American breast cancer patients enrolled in the Navigator-Assisted Hypofractionation (NAVAH) Phase I clinical trial. Methods: Six patients undergoing radiation therapy were assessed using the validated Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT) instrument. The mean score of the first 11 questions was used to classify individual FT as grade 0 (absent), grade 1 (mild), grade 2 (moderate), or grade 3 (severe), with lower scores indicating greater FT. Question 12 (Q12) was evaluated separately to measure FFT, with scores ranging from 0 to 4. An exploratory linear regression analysis examined the relationship between individual FT and FFT. Results: All patients reported mild or moderate individual FT, with Q12 scores ranging from 2 to 4. An exploratory linear regression analysis demonstrated a strong inverse association between individual COST-FACIT scores and Q12 scores ( r =−0.891, P =0.01). Lower COST-FACIT scores (indicating greater individual FT) were associated with higher Q12 scores, indicating greater perceived familial financial hardship. Conclusions: These findings suggest a strong association between individual and familial FT among Hispanic-American breast cancer patients. Assessing familial FT may help identify the broader economic impact of cancer treatment and inform supportive interventions addressing financial hardship among patients and their families.