PO-1469 A comprehensive score for financial toxicity in Japanese women: a pilot study before COVID-19 era

Purpose or Objective: Patients with financial toxicity (FT) have a lower quality of life and survival. In Japan, although the universal health insurance system has provided comprehensive coverage to all Japanese citizens, FT is increasingly recognized as an adverse outcome of cancer treatment. The poverty rate for elderly Japanese women is increasing;however, the FT of cancer treatment has been poorly studied in Japan. The comprehensive score for FT (COST) questionnaire is a tool to measure FT. In our study, we examined COST questionnaire among adult Japanese women receiving radiotherapy for breast cancer. Materials and Methods: Patients who were aged >18, had stage I–III A breast cancer, and received radiotherapy after breast-conserving surgery or mastectomy were eligible for the study. In addition to COST survey, socioeconomic characteristics were determined using a questionnaire and medical records. Results: All 17 patients we approached (100%) responded to the questionnaire. The median COST score was 17 (range, 9–38). Ten (59%) and five (29%) patients suffered grade 1 FT (COST score, 14–25) and grade 2 FT (COST score, 1–13), respectively. On univariant analyses, part-time job (P = .03), and lower household savings (P < .001) were negatively associated with COST score. Lower household income (P = .12) and use of strategies to cope with the cost of cancer care expenses (included using savings) to pay for cancer treatment (P = .13) did not show statistically significant associations. Conclusion: Our preliminary data showed that despite the existing universal health insurance system, some Japanese women experienced meaningful financial toxicity during radiotherapy. This is a preliminary report with a small number of patients before COVID-19 era. COVID-19 has the potential to affect patients economically. Therefore, a prospective study is underway to confirm the results under COVID-19 era.