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Spirituality and financial toxicity among Hispanic breast cancer survivors in New Jersey

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Abstract

Objective

Cancer survivors often incur significant out-of-pocket costs; this can result in financial toxicity, defined as the adverse financial impact of cancer due to direct or indirect costs related to the disease. There has been little research on whether spirituality is associated with the experience of financial toxicity. In this study, we tested the hypothesis that spirituality would be inversely associated with financial toxicity.

Methods

We evaluated these associations in a cross-sectional study of Hispanic breast cancer survivors (n = 102) identified through the New Jersey State Cancer Registry. Participants completed the FACIT-Sp-12, which has two spirituality subscales (meaning/peace; faith). Financial toxicity was assessed using the 11-item COST measure; lower scores suggest worse toxicity. In multivariable linear regression analyses, we examined the associations between spirituality scores and financial toxicity, adjusting for age, race, education, household income, and insurance status.

Results

The spirituality total score (β = 0.49, 95% confidence interval (CI): 0.17, 0.8), meaning/peace subscale score (β = 0.71, 95% CI: 0.12, 1.31), and faith (β = 0.71, 95% CI: 0.2, 1.21) subscale score were all inversely associated with financial toxicity.

Conclusions

Spirituality may be an important factor in ameliorating the detrimental effects of financial toxicity among Hispanic breast cancer survivors and should be considered in interventions for financial toxicity in this population.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Code availability

N/A.

Notes

  1. The rationale for using the term Hispanic in this article relates to the inclusion criteria of women whose origin dates to South America, Central America, the Caribbean, and Europe/Spain. We referred to the terms Latina and Latinx when citing authors who selected these terms under their own criteria.

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Acknowledgements

The study was funded by the Rutgers Cancer Institute of New Jersey. We thank the staff at the Rutgers Cancer Institute of New Jersey and the New Jersey State Cancer Registry for their contribution to the study. The project was supported by the Population Science Research Support Shared Resource at the Rutgers Cancer Institute of New Jersey. The New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey Department of Health, is funded by the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute under contract HHSN261201300021I and control No. N01-PC-2013-00021, the National Program of Cancer Registries (NPCR), Centers for Disease Control and Prevention under grant NU5U58DP006279-02-00, and the State of New Jersey and the Rutgers Cancer Institute of New Jersey.

Funding

The study was funded by the Rutgers Cancer Institute of New Jersey.

Author information

Authors and Affiliations

  1. Rutgers School of Public Health, Piscataway, NJ, USA

    Susana Echeverri-Herrera, Molly A. Nowels, Irina B. Grafova & Paul R. Duberstein

  2. Department of Sociology and Criminology, University of New Mexico, MSC05 3080, 1915 Roma NE Ste. 1103, Albuquerque, NM, USA

    Susana Echeverri-Herrera

  3. Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA

    Molly A. Nowels

  4. Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, NJ, New Brunswick, USA

    Bo Qin, Nur Zeinomar, Dhanya Chanumolu & Elisa V. Bandera

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  1. Susana Echeverri-Herrera
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Contributions

“All authors contributed to the study conception and design. Material preparation, data collection and/or analysis were performed by all authors. The first draft of the manuscript was written by Susana Echevarri Herrera and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.”

Corresponding author

Correspondence to Susana Echeverri-Herrera.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Rutgers University IRB (Pro2017000069).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Echeverri-Herrera, S., Nowels, M.A., Qin, B. et al. Spirituality and financial toxicity among Hispanic breast cancer survivors in New Jersey. Support Care Cancer 30, 9735–9741 (2022). https://doi.org/10.1007/s00520-022-07387-7

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