Auswirkungen der finanziellen Belastung auf die Lebensqualität bei deutschen Überlebenden von Kopf- und Halskrebs

Background: A significant financial burden (FB) is experienced by survivors of head and neck cancer (HNC) even in Germany, where statutory health insurance is in place. The financial toxicity of cancer can result in elevated morbidity and mortality rates, as well as a reduction in quality of life (QoL). The objective of our investigation is to elucidate the impact of HNC-related on QoL, with a view to facilitating a better understanding of the interplay between the two. Methods: A total of 200 patients, out of the 209 consecutive patients attending the university hospital's cancer aftercare program between August 2022 and March 2023, completed the EORTC QLQ-C30 questionnaire. The data from the QoL scale were analyzed based on the patients' self-reported FB. Parametric and non-parametric analyses were employed to evaluate the influence of FB and independent predictors on QoL and QoL scales. Causal diagrams were constructed to illustrate the causal relationship between these variables. Results: HNC patients reported a notable decline in their QoL as a consequence of financial burden. Significant detrimental effects of FB were observed on role functioning (RF; p = 0.0011), emotional functioning (EF; p = 0.0039), cognitive functioning (CF; p = 0.0149), and social functioning (SF; p = 0.0011). Advanced stage, advanced T category, and suffering from larynx/hypopharynx cancer demonstrated a significant quantitative interaction with FB, increasing the risk for impaired QoL with respect to RF, EF, CF, and SF. Conclusion: HNC survivors suffer from significant impaired QoL and FB after treatment. In general, FB impairs particular QoL scales, and these QoL scales are differentially affected by particular tumor characteristics, with FB jointly impairing QoL of HNC survivors.

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