Five-year trajectories of financial recovery in low-income breast cancer survivors.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9597-9597
Author(s):  
Victoria Susana Blinder ◽  
Sujata Patil ◽  
Francesca Gany ◽  
Rose C. Maly
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Low Income ◽  
Financial Stability ◽  
Breast Cancer Survivors ◽  
Financial Resources ◽  
Insurance Status ◽  
Breast And Cervical Cancer ◽  
Low Income Families ◽  
Financial Recovery

9597 Background: Breast cancer may have devastating consequences on the financial stability of low-income families due to its impact on employment and limited duration of emergency Medicaid coverage. Methods: A consecutive sample of 921 low-income, uninsured/underinsured, English/Spanish-speaking women diagnosed with breast cancer through the California Breast and Cervical Cancer Treatment Program was surveyed 6 months after diagnosis. Previously uninsured women were enrolled in MediCal. Follow-up surveys were administered at 18, 36, and 60 months. Our primary outcome was self-reported adequacy of financial resources. Trajectories of financial adequacy were compared by ethnicity and by trajectories of employment and insurance status. Results: 6 months after diagnosis, 38% said they had adequate financial resources to meet their needs, compared to 39%, 49%, and 55% at 18, 36, and 60 months, respectively. Trajectories of financial adequacy varied by ethnicity and by trajectories of employment and insurance status (Table). Of 549 who reported on financial resources in all 4 surveys the most common trajectory was inadequate resources in all surveys (n=120) followed by adequate resources in all surveys (n=83). Of 208 who had adequate resources at 6 months, 60% reported inadequate resources in ≥1 subsequent survey. Of 341 who had inadequate resources at 6 months, 87% reported inadequate resources in ≥1 subsequent survey. Conclusions: Low-income breast cancer survivors are at risk of long-term financial instability. Latinas and survivors who are not working and/or are uninsured are at highest risk. Additional research is needed to better understand the factors that impact financial recovery after treatment. [Table: see text]

Guideline-concordant surveillance and follow-up care among low-income patients with breast cancer: The role of primary care medical homes.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 171-171
Author(s):  
Stephanie B. Wheeler ◽  
Racquel Elizabeth Kohler ◽  
Ravi K. Goyal ◽  
Kristen Hassmiller Lich ◽  
Alexis Moore ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Low Income ◽  
Breast Cancer Survivors ◽  
Breast Cancer Survivorship ◽  
Medical Homes ◽  
Follow Up Care

171 Background: Community Care of North Carolina (CCNC) initiated an innovative medical home (MH) program in the 1990s to improve primary care in Medicaid-insured populations. CCNC has been successful in improving asthma, diabetes, and cardiovascular outcomes, but has not been evaluated in the context of cancer care. We sought to determine whether MH enrollment was associated with guideline-concordant surveillance and follow-up care among breast cancer survivors. Methods: Using state cancer registry records matched to Medicaid claims, we identified women ages 18-64 diagnosed with stage 0, I, or II breast cancer from 2003-2007 and tracked their CCNC enrollment. Using published American Society for Clinical Oncology breast cancer survivorship guidelines to define our outcomes, we employed multivariate logistic regressions to examine correlates of receipt of surveillance mammogram and at least two physical exams within 15 months post-diagnosis. Results: In total, 840 women were included in our sample. Approximately half were enrolled in a CCNC MH during the study period, 38% were enrolled for more than 7 months post-diagnosis. Enrollment in a MH for at least 7 months post-diagnosis was strongly associated with receiving guideline-recommended surveillance mammogram (p<0.01) and at least 2 physical exams (p<0.01) within 15 months post-diagnosis. Conclusions: Results suggest that MH enrollment is associated with higher quality breast cancer survivorship care among women insured by Medicaid. Given the growing population of cancer survivors and increased emphasis on primary care MH, more research is needed to explore how medical homes can enhance and ensure the provision of guideline-recommended care during cancer survivorship.

scholarly journals Return to work in low-income Latina and non-Latina white breast cancer survivors: A 3-year longitudinal study

Cancer ◽  
2011 ◽  
Vol 118 (6) ◽  
pp. 1664-1674 ◽  
Author(s):  
Victoria S. Blinder ◽  
Sujata Patil ◽  
Amardeep Thind ◽  
Allison Diamant ◽  
Clifford A. Hudis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Longitudinal Study ◽  
Return To Work ◽  
Cancer Survivors ◽  
Low Income ◽  
Breast Cancer Survivors

Employment status among low-income Caucasian and Latina breast cancer survivors

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6612-6612
Author(s):  
V. S. Blinder ◽  
S. Patil ◽  
A. Diamant ◽  
A. Thind ◽  
R. Maly
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Low Income ◽  
Care Provider ◽  
Employment Status ◽  
Breast Cancer Survivors ◽  
Personal Care ◽  
Job Type ◽  
Prospective Longitudinal ◽  
The Impact

6612 Background: Return to work (RTW) after breast cancer is associated with treatment recovery and quality of life. Prior research has found an 80% RTW rate in primarily Caucasian breast cancer survivors; however, little is known about the trajectory of RTW among Latinas. Qualitative research suggests that RTW is a major concern for Latinas. This study compares the rate of RTW between Latinas and Caucasians and investigates the role of job type in RTW. Methods: This is a prospective, longitudinal study of low-income, underserved breast cancer survivors who spoke English or Spanish, did not have metastatic disease, and were enrolled in the Medi-Cal Breast and Cervical Cancer Treatment Program. We interviewed survivors at 6 mos., 18 mos., and 3 yrs. after diagnosis to assess changes in employment status. The impact of independent variables including ethnicity, employment at diagnosis, job type, age, health status, and education was assessed using chi-square tests. Results: 666 survivors completed surveys at both 6 mos. and 3 yrs; 65% were Latina. The median age was 49 and 54 yrs. for Latinas and Caucasians, respectively (p < 0.001). 45% of Latinas had less than a high-school education compared to 3% of Caucasians (p < 0.001). The majority of Latinas worked in 3 job types: personal care-provider (23%), housekeeper (22%), and manufacturing (13%). Caucasians had greater job diversity, including clerical (15%), personal care-provider (13%), food preparer/server (12%), and sales (10%). At diagnosis, 51% of Latinas and 59% of Caucasians were employed (p = 0.07), and among these, Latinas were less likely to be working at 6 and 18 mos. than Caucasians (27% vs. 47% at 6 mos., p = 0.002 and 45% vs. 59% at 18 mos., p = 0.026). This difference dissipated by yr. 3 (53% of Latinas vs. 58% of Caucasians, p = 0.41). Job type at diagnosis was associated with RTW. Conclusions: Employed low-income Latinas and Caucasians appear to follow different RTW trajectories after breast cancer, with fewer Latinas working at 6 and 18 mos. Differences exist in job type between these populations; Caucasians have greater variation in job type and a trend toward greater likelihood of changing job type after breast cancer. This may reflect limitations in career choice among low-income Latinas and may be related to their protracted RTW trajectory. No significant financial relationships to disclose.

Supportive care priorities of low-income Latina breast cancer survivors

2018 ◽  
Vol 26 (11) ◽  
pp. 3851-3859 ◽  
Author(s):  
Alix G. Sleight ◽  
Kathleen Doyle Lyons ◽  
Cheryl Vigen ◽  
Heather Macdonald ◽  
Florence Clark
Keyword(s):  
Breast Cancer ◽  
Supportive Care ◽  
Cancer Survivors ◽  
Low Income ◽  
Breast Cancer Survivors

Low Income Deteriorates Quality of Life in Early Breast Cancer Survivors

2017 ◽  
Vol 41 (S1) ◽  
pp. S670-S671 ◽  
Author(s):  
G. Ristevska ◽  
D. Rajchanovska ◽  
T. Jovanovska ◽  
B. Dejanova
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Early Breast Cancer ◽  
Low Income ◽  
Breast Cancer Survivors ◽  
Economic Status ◽  
Socio Economic Status ◽  
Depressed Patients

BackgroundPatients who have survived cancer and have lower socio-economic status, are more likely to leave the workforce. Financial problems are widespread among many of the breast cancer survivors, but their effect on the quality of life are not sufficiently explored. The aim of this study is to assess the effect of low income onto quality of life in early breast cancer survivors.MethodsIn this study, 214 consecutive early female breast cancer patients, with mean age of 60 years (range 30–90), were interviewed for psycho-social aspects, depression (MINI) and quality of life (EORTC QLQ-Core 30 and BR-23). All patients were cancer free at the moment of interview and all initial oncological treatments were completed. Monthly net family income distribution was: ≤150 euro 58 patients (27.1%); income between 150–500 euro 116 patients (54.2%); ≥500 euro 40 patients (18.7%).ResultsPatients with income ≤150 euro, compared to patients with income ≥500 euro, had statistically significant worse global health status (60.2 ± 27.9 vs. 80.2 ± 19.2; P = 0.0007); worse physical functioning (80.3 vs. 69.1; P < 0.001); worse role functioning (92.9 vs. 78.7; P = 0.009); worse sexual functioning (P = 0.019); more severe fatigue (38 vs. 23; P = 0.01), nausea/vomitus (P = 0.041), appetite loss (18.4 ± 7.5). Major depression was diagnosed in 35 patients. Depressed patients have less income than not depressed patients (23.3% vs. 14.41%), but the difference did not reach statistical significance.ConclusionsLower income negatively affects many aspects of quality of life. Specific interventions are needed for cancer survivors with lower socio-economic status to preserve and improve the quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prevalence and correlates of fatigue and depression in breast cancer survivors: Breast cancer quality care study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 683-683
Author(s):  
S. H. Kim ◽  
B. W. Park ◽  
S. H. Ahn ◽  
D. Y. Noh ◽  
S. J. Nam ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Low Income ◽  
Breast Cancer Survivors ◽  
Gastrointestinal Disease ◽  
Quality Care ◽  
Severe Depression ◽  
Survey Study ◽  
Appetite Loss ◽  
European Organization

683 Background: Fatigue and depression may persist for months or even years after completion of breast cancer treatment. We investigated the prevalence and correlates of fatigue and depression in disease-free breast cancer survivors. Methods: 1,933 breast cancer survivors recruited from five large hospitals in Korea completed standardized questionnaires as part of a survey study, including the patient demographics, Brief Fatigue Inventory, Beck Depression Inventory, European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and QLQ-BR23. Women were eligible to participate if they had a past diagnosis of breast cancer (stage 0, I, II, or III) and were currently free of the disease more than one year. Eligible patients were contacted by telephone, and those who agreed to participate were sent the questionnaire with consent forms and a postage-paid return envelope. Multivariate logistic regression models were used to identify factors associated with fatigue and depression. Results: Sixty six percent of the breast cancer survivors reported moderate to severe fatigue, which was defined as a “fatigue worst” rating of 4 or greater, 24.9% reported clinical moderate to severe depression, which was defined as a rating of 19 or greater. Fatigue and depression were highly correlated (Pearson r=.593). Fatigue was associated with significantly employment status (OR=1.58), low income (OR=1.29), having gastrointestinal disease (OR=1.94), dyspnea (OR=2.15), appetite loss (OR=3.02), insomnia (OR=2.72), breast symptoms (OR=1.82), and hair loss (OR=1.75). Depression was strongly related to low income (OR=2.50), fatigue (OR=4.52), insomnia (OR=1.98), appetite loss (OR=2.24), constipation (OR=2.12), and financial difficulties (OR=1.89), systemic therapy side effect (OR=3.12). Fatigue and depression were negatively associated to QOL. Conclusion: There were subgroups of survivors who report more severe and persistent fatigue and depression. This information may be helpful in elucidating the mechanisms underlying fatigue and depression in this population, as well as directing intervention efforts. No significant financial relationships to disclose.

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