Finance and work changes among caregivers of patients with metastatic colorectal cancer (mCRC): Secondary analysis of SWOG S1417CD.

297 Background: We previously found that nearly 75% of mCRC patients enrolled in a multicenter, longitudinal, prospective cohort study (S1417CD) reported major financial hardship following diagnosis. Here, we present the results of secondary analyses on work- and finance-related impacts among patients’ caregivers. Methods: Caregivers of community oncology patients with mCRC who enrolled in S1417CD were provided the option to participate by completing surveys on financial and work-related impacts related to cancer caregiving. Caregivers were surveyed at study entry, 6, and12 months. Work-related changes were defined as reducing hours or quitting, taking leave, leaving one job for another, using sick leave or vacation time, or working an additional job/hours. Financial impacts included drawing from savings/retirement accounts, taking out a new loan, increasing employment, declaring bankruptcy, or reducing spending. We used multivariate logistic regression to evaluate the association between caregiver characteristics (relationship type, shared household finances, sex, income, children, and whether they primarily managed financial aspects of treatment) and patient characteristics (whether they reported insurance via current or former employer), and experiencing work- or finance-related impacts during the first 12 months. Results: 111 caregivers out of 380 enrolled patients completed a baseline and at least one follow-up survey. 68% of caregivers reported shared finances/income with the patient to whom they provided care, 16% were also the primary caregiver for a person other than the enrolled patient, and 26% had children <18 in their household. 57% (63/111) of caregivers made a work-related change during the study period and 78% (87/111) experienced a financial impact. Having children <18 in the household was associated with greater likelihood of making a work-related change (OR 5. 89, p = 0. 002). Caregivers whose employment type changed while cancer caregiving had a variety of pre-diagnosis employment types, including paid full time work (5/22, 23%), paid part-time work (4/22, 18%), not being employed (6/22, 27%), and being retired, volunteer, on disability, or another employment type (7/22, 32%). Total income ≤100, 000 was associated with a greater likelihood of experiencing a financial impact (OR 3. 34, p = 0. 024), adjusted for work-related change. Conclusions: In this national sample, caregivers of patients with mCRC experienced significant financial and work impacts during 12 months of treatment; caregivers with children in the home and those with lower income were particularly affected. These findings suggest that interventions aimed at addressing financial challenges facing cancer patients and caregivers, particularly groups at higher risk for these events, warrant future study to mitigate the financial and work impacts of cancer caregiving.