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Racial variation in willingness to trade financial resources for life-prolonging cancer treatment

  1. Michelle Y. Martin PhD1,†,*,
  2. Maria Pisu PhD1,
  3. Robert A. Oster PhD1,
  4. Julie M. Urmie PhD2,
  5. Deborah Schrag MD3,
  6. Haiden A. Huskamp PhD4,
  7. Jeannette Lee PhD5,
  8. Catarina I. Kiefe PhD, MD6,
  9. Mona N. Fouad MD, MPH1

Article first published online: 26 APR 2011

DOI: 10.1002/cncr.25839

Issue

Cancer

Cancer

Volume 117, Issue 15, pages 3476–3484, 1 August 2011

Additional Information

How to Cite

Martin, M. Y., Pisu, M., Oster, R. A., Urmie, J. M., Schrag, D., Huskamp, H. A., Lee, J., Kiefe, C. I. and Fouad, M. N. (2011), Racial variation in willingness to trade financial resources for life-prolonging cancer treatment. Cancer, 117: 3476–3484. doi: 10.1002/cncr.25839

Author Information

  1. 1

    Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama

  2. 2

    University of Iowa College of Pharmacy, Iowa City, Iowa

  3. 3

    Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts

  4. 4

    Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts

  5. 5

    Department of Biostatistics, University of Arkansas, Little Rock, Arkansas

  6. 6

    Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts

  1. †

    Fax: (205) 975-6753

*University of Alabama at Birmingham, Department of Medicine, Division of Preventive Medicine, 1530 Third Ave South, MT 617, Birmingham, AL 35294-4410

  1. †

    Fax: (205) 975-6753

Publication History

  1. Issue published online: 20 JUL 2011
  2. Article first published online: 26 APR 2011
  3. Manuscript Accepted: 16 NOV 2010
  4. Manuscript Revised: 11 NOV 2010
  5. Manuscript Received: 14 SEP 2010

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Keywords:

  • treatment;
  • preferences;
  • cancer;
  • race;
  • financial resources;
  • tradeoffs

Abstract

BACKGROUND:

Minority patients receive more aggressive care at the end of life, but it is unclear whether this trend is consistent with their preferences. We compared the willingness to use personal financial resources to extend life among white, black, Hispanic, and Asian cancer patients.

METHODS:

Patients with newly diagnosed lung or colorectal cancer participating in the Cancer Care Outcomes Research and Surveillance observational study were interviewed about myriad aspects of their care, including their willingness to expend personal financial resources to prolong life. We evaluated the association of race/ethnicity with preference for life-extending treatment controlling for clinical, sociodemographic, and psychosocial factors using logistic regression.

RESULTS:

Among patients (N = 4214), 80% of blacks reported a willingness to spend all resources to extend life, versus 54% of whites, 69% of Hispanics, and 72% of Asians (P<.001). In multivariate analyses, blacks were more likely to opt for expending all financial resources to extend life than whites (odds ratio, 2.41; 95% confidence interval, 1.84-3.17; P < .001).

CONCLUSIONS:

Black cancer patients are more willing to exhaust personal financial resources to extend life. Delivering quality cancer care requires an understanding of how these preferences impact cancer care and outcomes. Cancer 2011;. © 2011 American Cancer Society.

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