Financial toxicity among head and neck cancer patients and their caregivers: A cross-sectional pilot study

Oliver T. Nguyen, Umberto Donato, Rachael McCormick, Maija Reblin, Lindsay Kim, Emma Hume, Amy K. Otto, Amir Alishahi Tabriz, Jessica Y. Islam, Young Rock Hong, Kea Turner, Krupal B. Patel

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objectives: Head and neck cancer (HNC) patients experience greater financial toxicity than other cancer patients. Research on financial toxicity has concentrated on patients despite many informal caregivers sharing finances and reducing work hours to provide patient care. Thus, our pilot study: (1) assessed the feasibility of financial toxicity screening of HNC patients and their caregivers, and (2) described financial toxicity levels of HNC patients and their caregivers. Methods: We surveyed English-speaking adult HNC patients initiating treatment at a National Cancer Institute-designated Comprehensive Cancer Center and their informal caregivers. This survey assessed demographics and financial toxicity through the Comprehensive Score for Financial Toxicity (COST) measure (0–44 range; lower score indicates higher financial toxicity). Screening feasibility was defined as ≥50% consent rate and ≥60% data completion rate. Results: Our sample included 27 HNC patients and 9 caregivers. They both had slightly lower consent and completion rates than our goals. Patients reported a median COST score of 27 while caregivers reported a median COST score of 16. Approximately 25.9% of patients and 44.4% of caregivers reported high financial toxicity (COST < 17.5). Caregivers reported high concerns about their future financial health and their ability to control the amount of their financial contributions to the patient's care. Conclusions: Patients and caregivers may require additional outreach approaches beyond emailed questionnaires to screen for their financial toxicity systematically. Future research is needed to replicate our results to determine whether differences in financial toxicity occur between patients and caregivers and identify areas of focus for interventions. Level of evidence: IV.

Original languageEnglish (US)
Pages (from-to)450-457
Number of pages8
JournalLaryngoscope investigative otolaryngology
Issue number2
StatePublished - Apr 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.


  • caregivers
  • financial burden
  • financial toxicity
  • head and neck cancer

PubMed: MeSH publication types

  • Journal Article


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