Financial toxicity and its associated patient and cancer factors among women with breast cancer in China.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19402-e19402
Author(s):  
Jingfeng Jing ◽  
Ran Feng ◽  
Xiaojun Zhang ◽  
Ming Li ◽  
Jinnan Gao

e19402 Background: The term “Financial toxicity(FT)” is widely used to describe the distress or hardship patients suffering from the financial burden of cancer treatment[1]. Increased evidences have showed that cancer-associated FT is common and has a negative impact on patients’ mental health, quality and length of life[1,2]. The scale of COmprehensive Score for financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT) was used to assess the FT of cancer patients, which has been validated and widely used internationally [3] and China [4]. To our knowledge, little is known about the FT of breast cancer patients in China. The aim of this study is to assess the FT and to investigate patients and cancer characteristic that associated with it in patients in central China. Methods: This was a cross-sectional study among 188 patients with stage 0-III women breast cancer admitted in Bethune hospital in Taiyuan, Shanxi province during January - May 2019. FT was self-reported using the COST-FACIT. Patients’ socio-demographic factors, clinical examination, and cancer treatment were collected from questionnaire and hospital record. The financial concern and coping strategy was self-reported. Factors associated with FT was identified using linear regression analysis. Results: One hundred and sixty-six (88.2%) completed the questionnaire. The COST score ranged 0-40 with a mean of 21.2 (median 22.5, standard deviation 8.1). On multivariate linear regression analysis, older age (β coefficient: 0.19, 95% CI: 0.10-0.29, p<0.001), higher household income (β coefficient: 3000-5000 Yuan: 6.48, 95% CI: 2.78-10.17, p =0.001; ≥ 5000 Yuan: 11.17, 95% CI: 7.25-15.09, p<0.001) were positively associated with COST scores. Advanced cancer stage was the strongest predictor of FT among the cancer characteristics (β coefficient: -1.81, 95% CI: -3.17, -0.46, p=0.009). To cope with the FT, 131 (78.8%) patients decreased non-medical expenses, and 56 (33.7%) reduced or quit treatment. Conclusions: FT was significantly associated with patient’s age, income, and cancer stage. Women having financial concerns after diagnosis were more likely to reduce their non-medical expenses and even quit treatments. Clinicians should take into account the FT levels in all patients and work out appropriate treatment strategies for optimal clinical outcome.

2012 ◽  
Vol 5 (1) ◽  
pp. 103-118
Author(s):  
Christiaan Smit ◽  
Merwe Oberholzer ◽  
Suria Ellis

This study challenges the fairness of sectional title schemes’ levies that are ordered by the Sectional Title Act (95 of 1986) to be allocated according to the participation quota (floor area) of units. Studies have shown that larger units in a sectional title scheme tend to subsidise the levies of smaller units. A log-transformed linear regression analysis was performed to investigate the cost behaviour of 113 sectional title schemes. The results revealed that 86% of the variation in the operating costs of a scheme is attributable to the variation in the area of a scheme, while 87% of the variation in operating costs is attributable to a variation in the number of units in a scheme. The conclusion is that the area and the number of units in a scheme are equally significant drivers of operating costs. Therefore, the study recommended that the levies should be allocated on a 50/50 basis with regard to area and number of units.


2020 ◽  
Vol 14 ◽  
pp. 117822342097784
Author(s):  
Abdulmohsen Alkushi ◽  
Ahmad Omair ◽  
Haitham Arabi ◽  
Emad Masuadi ◽  
Omalkhair Abualkhair

Background: Oncotype Dx is used to predict the long-term recurrence risk in patients with estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative invasive breast cancer (BC). This study aimed at establishing a correlation between clinicopathological parameters and recurrence score (RS), subsequently improving predictability and ultimately justifying the use of the multigene assay. Materials and methods: A retrospective analysis of the pathology and clinical data of 114 female patients with BC who had Oncotype Dx testing between 2012 and 2019. The pathological parameters included are tumor cell type, tumor grade, pathological stage, and mitotic index (MI). The expression of ER, progesterone receptor (PR), HER2, and Ki67 was assessed by immunohistochemistry. A univariate and multivariate linear regression analysis was performed to assess the correlation between these parameters and the RS. Results: In univariate analysis, age (˂40 years), higher tumor grade, and low PR expression were significantly associated with higher RS ( P = .02; ˂.001; and ˂.001, respectively). Both MI and Ki67 were also strongly correlated with an increase in the RS with a P value of .01 (Spearman correlation 0.34 and 0.33). In multivariate linear regression analysis, age, MI, and Ki67 lost their significance, but both higher grade and PR remained significantly associated with a higher RS along with the tumor stage ( P ˂ .001; ˂.001; and .04, respectively). Conclusions: Tumor grade and PR immunohistochemical expression are the main predictors of RS in our study population. Other clinicopathological features were not significant predictors of change in RS in multivariate analysis.


2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 205-205
Author(s):  
David G Li ◽  
Gabrielle LeCompte ◽  
Lihong Mo ◽  
Miranda Weintraub ◽  
David Irwin ◽  
...  

205 Background: Breast cancer is the most prevalent malignancy among women worldwide. Increased levels of oxidative stress are associated with breast cancer incidence. This study assesses physical, behavioral, and subjective health correlates of oxidative stress and associations between oxidative stress and breast cancer stage. Methods: Current and previous breast cancer patients were asked to participate in this cross-sectional study. After assessing Electronic Medical Record (EMR), a sample of 149 patients met the inclusion criteria. A final sample of 102 (68%) were enrolled. Patients’ skin carotenoid scores (SCS), a dermal measure of oxidative stress, were recorded. Patient demographics, physical health (breast cancer stage, treatment status, weight, height) health behaviors (smoking status, diet) and subjective health (anxiety and self-rated health) were ascertained. Results: No correlation between breast cancer stage and SCS was found. SCS was associated with behavioral health, weight and height (p<0.05), a finding consistent with previous research. A multivariate linear regression analysis, controlling for all covariates, found the two subjective health measures to be associated with SCS scores; the presence of anxiety was associated with lower SCS scores, a novel finding (β=-0.48, 95% CI -0.93, -0.035). Moreover, self-rated health was inversely correlated with SCS, showing those with lower self-reported quality levels paradoxically had higher levels of SCS (β=19.89, 95% CI 6.12, 33.67). Conclusions: Although oxidative stress as measured by SCS may not be associated with breast cancer staging, future research should explore the causal relationship between oxidative stress and subjective stress. Results suggest an unknown biochemical mechanism linking increased levels of oxidative stress with lower subjective health scores. Findings of the study indicate the possibility of utilizing SCS as an objective correlate to gauge an individual’s subjective stress levels in order to optimize cancer treatment.


2021 ◽  
Vol 6 (3) ◽  
pp. 95
Author(s):  
Rimat Maulana ◽  
Lukman Yunus ◽  
Samsul Alam Fyka

This study aims to determine what factors influence land conversion from lowland rice plantations to lime plantations in Watabenua Village, Landono District. The population in this study were all farmers who had converted land in Watabenua Village, Landono District, South Konawe Regency, and as many as 33 people, where all were used as samples by the census method 33 respondents. The analytical method used is multiple linear regression analysis. The results of this study are the factors that affect the conversion of land from lowland rice plantations to lime plantations in Watabenua Village are the cost of citrus production. In contrast, the factors that do not affect land conversion are rice income, the distance between irrigation water sources to rice fields, the price of another product, namely oranges.


Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4575-4575
Author(s):  
Daniel J. Lachant ◽  
Kanu P. Sharan ◽  
Andres Ferber ◽  
Robert Somer ◽  
Generosa Grana ◽  
...  

Abstract Aromatase inhibitors (AI) block the conversion of testosterone and androstenedione to the estrogen estrone by inhibiting the aromatase enzyme complex. AI are used to treat estrogen receptor positive (ER+) breast cancer in postmenopausal women. With AI therapy, estrogen levels decrease to 85–95% of baseline. In women with metastatic disease, androstenedione levels do not increase. We have evaluated 2 women for polycythemia during AI therapy. Case 1 is 52 years old with stage II breast cancer treated with lumpectomy, TAC × 6 and radiation. Tamoxifen was started 4 months later. The mean hemoglobin during 6 months of tamoxifen was 14.0±0.1 gm/dl. When switched to exemestane, the mean hemoglobin over the next 24 months was 16.1±0.5 gm/dl (Mann-Whitney, p&lt;0.003). Case 2 is an 80 year old with stage I breast cancer treated with lumpectomy followed by radiation. Her baseline hemoglobin was 13.8 gm/dl. 26 months after starting exemestane, her hemoglobin reached 18.0 gm/dl. After extensive evaluation, neither patient met the criteria for polycythemia vera and no etiology for secondary polycythemia was found. The presumption was that the temporal increase in hemoglobin may be due to AI therapy. Previous clinical trials have not reported an increase in hemoglobin in women receiving AI therapy for breast cancer. However, given the dramatic increase in hemoglobin in our 2 patients, we wished to test the hypothesis that inhibition of aromatase may lead to an increase in hemoglobin in postmenopausal women receiving AI therapy for breast cancer. The Cooper University Hospital Tumor Registry was used as a source of potential subjects. Women over the age of 50 years, diagnosed with ER+ nonmetastatic breast cancer between 2002 and 2006 were identified. Women included for study were postmenopausal, and treated with breast surgery +/− local radiation. Women receiving chemotherapy were excluded because of the potential effect of chemotherapy or therapeutic erythropoietin on the hemoglobin level. In order to be included for study, women needed to have a hemoglobin prior to surgery or prior to starting anti-estrogen therapy and at least 3 hemoglobin measurements over a minimum of 12 months after starting anti-estrogen therapy. AI included anastrozole and exemestane. Of 123 charts available for review, 82 had inadequate data for analysis. 27 evaluable women received only an AI. The mean age was 67±8 years and 67% were stage I. The mean hemoglobin before and during AI therapy was 13.7±0.4 and 13.2±1.1 gm/dl, respectively (Mann Whitney, p&lt;0.09). 3/27 had an increase in hemoglobin after starting AI therapy by linear regression analysis (r ≥ 0.60). The increase in hemoglobin ranged from 0.9 to 1.1 gm/dl. As a control group, 11 women received tamoxifen rather than an AI. Mean age was 59±8 years and 54% were stage I. The mean hemoglobin before and during tamoxifen therapy was 13.0±1.0 and 12.8±0.8 gm/dl, respectively (Mann Whitney, p=0.53). 0/11 had an increase in hemoglobin by linear regression analysis (r &gt; 0.60). 2 additional women received tamoxifen which was subsequently changed to an AI, 1 of whom had a mean hemoglobin of 12.9±0.3 gm/dl on tamoxifen which increased to 14.9±0.4 gm/dl on exemestane (Mann Whitney, p&lt;0.05). 1 additional woman had a rise in hemoglobin of &gt; 1 gm/dl while on AI therapy which decreased back to baseline when switched to tamoxifen. In conclusion, although the numbers are small and the data retrospective, these data suggest that AI therapy may be associated with an increase in hemoglobin in a subgroup of women treated with AI therapy for localized breast cancer. Given that AI have not been shown to significantly increase the systemic androgen level, the mechanism for the increase in hemoglobin remains unclear. A well designed, prospective study is needed to determine if AI have an effect on hemoglobin in women being treated for breast cancer.


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Jian Dong ◽  
Yu Chen ◽  
Aihua Gu ◽  
Jingwei Chen ◽  
Lili Li ◽  
...  

How to reduce the cost of competition in the industry, identify effective customers, and understand the emotional needs and consumer preferences of customers, so as to carry out fast and accurate commercial marketing, is an important research topic. In this paper, we discussed the method for the analysis of three product data which represent the customer-supplied ratings and reviews for microwave ovens, baby pacifiers, and hair dryers sold in the Amazon marketplace over the time period. The sentiment analysis, linear regression analysis, and descriptive statistics were implemented to analyze the three datasets. Based on the sentiment analysis given by the naive Bayesian classification algorithm, we found that the star rating is positively correlated with the reviews, while the helpfulness ratings have no specific relationship with the star rating and reviews. We use multiple regression analysis and clustering algorithm analysis to get the relationship between the 4 indexes such as time, star rating, reviews, and helpfulness rating. We find that there is a positive correlation between the 4 indexes, and the reputation of the product online market is improving as time grows. Based on the analysis of the positive reviews and star ratings, we suggested indicating a potentially successful or failing product by the positive reviews. We also discussed the relations between the star ratings and number of reviews. Finally, we selected the words from the Amazon sentiment dictionary as candidate words. By counting the candidate words’ appearance in the review, the keywords that can reflect the star rating were found.


2019 ◽  
Vol 4 (2) ◽  
pp. 245 ◽  
Author(s):  
Abdul Gaffar Rafid ◽  
Hotman Tohir Pohan ◽  
Ice Nasyrah Noor

<p><em>The Study examined the effect of the allocation of the cost of social responsibility as a proxy of the disclosure of Corporate Social Responsibility) on the relationship between ROA as a proxy of the financial performance of the company’s value and the impact of the cost allocation of social responsibility as a proxy of the financial performance of the company’s value. The purpose of research is to find empirical evidence of (a) the effect of financial performance ROA on firm value, (b) the effect of the financial performance of CR on firm value (c) the effect of CSR on the relationship between ROA enterprise value (d) the effect of CSR on the relationship between CR with the value of the company.</em></p><p><em>The sample in this research is manufacturing companies listed in Indonesia Stock Exchange (IDX) in the range of 2013-2015. Samples were as many 33 companies with 95 observation. Analysis of data using multiple linear regression analysis.</em></p><em>Result of research by linear regression analysis showed that the ROA have negative significant effect on firm value. Than the results of linear regression analysis showed that the CR also has a negative significant effect on firm value. Furtermore, linear regression analysis reveals that the disclosure of CSR is not able to oderate the relationship between ROA on firm value. But unlike the CR, research results show that the disclosure of CSR is able to moderate the relationship between CR on firm value. Simulataneous the independent variable affects the company’s value.</em>


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18299-e18299 ◽  
Author(s):  
Jennifer Spencer ◽  
Katherine Elizabeth Reeder-Hayes ◽  
Laura C Pinheiro ◽  
Lisa A. Carey ◽  
Andrew F Olshan ◽  
...  

e18299 Background: High cancer treatment costs are associated with considerable distress and worse outcomes in cancer patients, a phenomenon known as “financial toxicity”. We examined changes in health-related quality of life (HRQoL) among women experiencing financial toxicity after cancer diagnosis compared to cancer patients without financial toxicity in a racially diverse cohort of breast cancer patients. Methods: HRQoL was self-reported at approximately 5 and 25 months post-diagnosis using the Functional Assessment of Cancer Treatment (FACT-G) in a prospective, population-based, cohort study with oversampling of Black and young (<50 years old) women. Women reported on the financial burden of their breast cancer, including whether they had declined or delayed care due to cost or transportation barriers and whether they lost a job, experienced a reduction in household income, or lost insurance coverage after their cancer diagnosis. We assessed changes in HRQoL from 5 to 25 months according to financial toxicity experience. Results: 2,432 women completed 5- and 25-month HRQoL surveys and were included in analyses. Forty-nine percent were non-Hispanic Black and 51% were non-Hispanic White; other minorities were excluded due to small numbers. Overall, 49% of women reported at least one indicator of financial toxicity (59% Black vs. 39% White). Women who reported any financial toxicity had significantly lower scores on the FACT-G at baseline (75.5 vs 87.2, p<0.001) and reported significantly less improvement in HRQoL from 5- to 25-months than women who did not report financial toxicity (incremental difference: +1.4 vs +3.8, p=.01). Black women reported lower overall HRQoL than White women (p=0.03), but impact of financial toxicity on HRQOL was similar among black and white women in stratified analyses. Conclusions: Financial toxicity is associated with lower HRQoL and with less improvement in HRQoL in the two years following breast cancer diagnosis. [Table: see text]


2021 ◽  
Vol 23 (1) ◽  
pp. 94-108
Author(s):  
Muhammad Rivandi ◽  
Elvonika Retno Kemala

The purpose of this study is to provide empirical evidence regarding the influence of motivation, cost of education and length of education on student interest in taking accounting profession education (PPAk) at Dharma Andalas University, Padang. The population in this study were 152 students of the Department of Accounting 2015-2017 at Dharma Andalas University. Purposive sampling technique is a sampling technique used in this study. The sample in this study were 117 students of accounting class 2015-2017 at Dharma Andalas University. This type of research is quantitative research. Multiple linear regression analysis was used in this study. The results showed that motivation had no significant effect on student interest in attending PPAk which was indicated by a significant value of 0.131, while the cost of education and length of education had a positive and significant effect on student interest in attending PPAk levels which was indicated by a significant value. 0.004 and 0.021 ABSTRAK Tujuan penelitian ini adalah untuk memberikan bukti empiris mengenai pengaruh motivasi, biaya pendidikan dan lama pendidikan terhadap minat mahasiswa menempuh pendidikan profesi akuntansi (PPAk) di Universitas Dharma Andalas Padang. Populasi dalam penelitian ini adalah 152 mahasiswa Jurusan Akuntansi 2015-2017 Universitas Dharma Andalas. Teknik purposive sampling merupakan teknik pengambilan sampel yang digunakan dalam penelitian ini. Sampel dalam penelitian ini adalah 117 mahasiswa akuntansi angkatan 2015-2017 Universitas Dharma Andalas. Jenis penelitian ini adalah penelitian kuantitatif. Analisis regresi linier berganda digunakan dalam penelitian ini. Hasil penelitian menunjukkan bahwa motivasi tidak berpengaruh signifikan terhadap minat siswa mengikuti PPAk yang ditunjukkan dengan nilai signifikan sebesar 0,131, sedangkan biaya pendidikan dan lama pendidikan berpengaruh positif dan signifikan terhadap minat siswa mengikuti PPAk yang diindikasikan dengan nilai yang signifikan. 0,004 dan 0,021


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Wu-yun Wang ◽  
Miao-fang Wu ◽  
Dong-bing Wu ◽  
Li-juan Wang ◽  
Hui Li ◽  
...  

Abstract Background Hyperthermic intraperitoneal chemotherapy (HIPEC) is an important treatment for ovarian cancer. A certain portion of cisplatin exits the body via the perfusate at the end of HIPEC, so full-dose utilization cannot be achieved. Herein, we sought to explore how much cisplatin is actually utilized and its prognostic influence. Methods Cisplatin (70 mg/m2) was given at 43 °C for 90 min. The actually utilized dose (AD) of cisplatin was calculated using the following formula: AD (mg) = total dose (TD) (mg)-losing dose (LD) (mg); LD = volume (ml) of the perfusate (VPretained) that was retained in the HIPEC treatment system at the end of HIPEC * concentration of cisplatin in the perfusate (mg/ml). Result Sixty-two ovarian cancer patients were included. The median TD, median LD and median AD were 95 mg, 20.7 mg and 75.8 mg, respectively. The utility rate of cisplatin (AD/TD ratio) was 79.2%. On simple linear regression analysis, the TD and VPretained were found to significantly predict the AD. Based on these two factors, multiple linear regression analysis was conducted, and a significant regression equation was formulated [F (2, 59) = 71.419, P < 0.0001]: predicted AD (mg) = 30.079 + 0.667 TD (mg) – 0.010 VPretained (ml) (adjusted R2 = 0.698). In Cox regression analysis, AD was not noted to be associated with progression free survival or overall survival. Conclusion For ovarian cancer patients who receive cisplatin for HIPEC at 43 °C, the AD of cisplatin can be predicted using a regression equation and it has no prognostic impact.


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