The personal financial burden of complications after colorectal cancer surgery

Authors

  • Scott E. Regenbogen MD, MPH,

    1. Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
    2. Department of Surgery, University of Michigan, Ann Arbor, Michigan
    Search for more papers by this author
  • Christine M. Veenstra MD,

    1. Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
    Search for more papers by this author
  • Sarah T. Hawley PhD, MPH,

    1. Cancer Surveillance and Outcomes Research Team, University of Michigan, Ann Arbor, Michigan
    Search for more papers by this author
  • Mousumi Banerjee PhD,

    1. Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
    2. Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
    Search for more papers by this author
  • Kevin C. Ward PhD, MPH,

    1. Department of Epidemiology and Georgia Center for Cancer Statistics, Rollins School of Public Health, Emory University, Atlanta, Georgia
    Search for more papers by this author
  • Ikuko Kato PhD,

    1. Department of Oncology, Wayne State University, Detroit, Michigan
    2. Department of Pathology, Wayne State University, Detroit, Michigan
    Search for more papers by this author
  • Arden M. Morris MD, MPH

    1. Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
    2. Department of Surgery, University of Michigan, Ann Arbor, Michigan
    3. Cancer Surveillance and Outcomes Research Team, University of Michigan, Ann Arbor, Michigan
    Search for more papers by this author

  • Presented at the Academic Surgical Congress; San Diego, California; February 4-6, 2014.

  • The views expressed herein do not necessarily represent the views of the American Cancer Society.

Corresponding author: Scott E. Regenbogen, MD, MPH, 2800 Plymouth Road, Building 16, 100N-28, Ann Arbor, MI 48109; Fax: (734) 232-6189; sregenbo@med.umich.edu

Abstract

BACKGROUND

Patients with colorectal cancer (CRC) may suffer significant economic hardship during treatment. Complications are common after surgery for CRC and may exacerbate the financial burden of CRC even further.

METHODS

Within a population-based survey of patients with stage III CRC, the authors investigated the effects of disease and treatment on personal finances and computed a composite measure of financial burden. Correlations were examined between components of financial burden and patient-reported postoperative complications using chi-square analyses, and Mantel-Haenszel chi-square tend tests were used to evaluate correlations between composite financial burden scores and surgical complications, controlling for patient characteristics and other factors by using multivariable Poisson regression.

RESULTS

Among 937 respondents, 224 (24%) reported complications after surgery. Those with complications had significantly higher composite financial burden (P < .001 for trend): they were more likely to spend savings (40% vs 31%; P = .01), borrow or take loans (18% vs 11%; P = .007), fail to make credit card payments (18% vs 11%; P = .005), reduce spending for food or clothes (38% vs 27%; P = .001), and decrease recreational activities (41% vs 33%; P = .03). They took significantly longer to return to work (P = .009) and were more likely to experience significant worry about finances (61% vs 52%; P = .01).

CONCLUSIONS

Complications after surgery for CRC result in significant personal financial consequences as well as morbidity. Financial stress impairs quality of life and may prevent adherence to recommended treatments. Therefore, patients who suffer complications may require not just additional clinical care but also economic support and services. Cancer 2014;120:3074–3081. © 2013 American Cancer Society.

Ancillary