Status of financial toxicity and its influence on quality of life in patients with gynecological malignancies in China
Background
Gynecological malignancies impose a substantial health and economic burden in China. The high cost of treatment often results in considerable financial toxicity, placing economic strain on patients and their families. These challenges can reduce treatment adherence, heighten emotional distress, and impair quality of life. This study aims to assess the degree of financial toxicity among patients with gynecological cancers, evaluate its impact on quality of life, and provide evidence to support the development of targeted clinical interventions to mitigate its adverse effects.
Methods
A convenience sampling approach was employed to recruit 281 patients with gynecological malignancies from two hospitals in Nanjing. A cross-sectional survey was conducted between November 2022 and December 2024. Data were collected using general information questionnaires, the financial toxicity comprehensive scale, and the cancer patient quality-of-life assessment scale.
Results
Data validity was confirmed using Harman’s single-factor test (first factor explanatory rate was 30.44%). The mean ± SD total financial toxicity score of the patients was 20.80 ± 7.32 points, with 73% (205/281) experiencing significant financial burdens. The financial resource dimension had the lowest mean score 3.40 ± 1.37 points. Multivariate linear regression analysis indicated that the age of children, family per capita monthly income, treatment costs in the past three months, and marital status were the core influencing factors (adjusted R 2 = 0.310). The mean ± SD total quality of life score of the patients was 65.79 ± 11.39 points, and the total financial toxicity score was significantly positively correlated with quality of life ( r = 0.553, P < 0.01). Participants had a mean age of 52.27 ± 10.78 years; cervical cancer accounted for the highest proportion (49.5%); 29.2% were unemployed or had resigned due to illness, and 96.8% reported medical expenses exceeding CNY 5,000 (roughly $701.50) in the past three months.
Conclusion
The majority of studied patients experienced financial toxicity, with financial status, family dynamics, and widowhood being key influencing factors.