ArticleBreast cancer research and treatment2023
Breast cancer treatment receipt and the role of financial stress, health literacy, and numeracy among diverse breast cancer survivors.
Article in Breast cancer research and treatment, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 9 citations in OpenAlex.
- The LIFT UP study: feasibility of systematically identifying and addressing resource needs in those with metastatic breast cancer.Breast cancer research and treatment · 2026Article
- The relationship of race/ethnicity and age with medical financial hardship for cancer survivors in the United States.Journal of cancer survivorship : research and practice · 2026Article
- Expression Characteristics of PAX7 and Its Prognostic Correlation in Breast Cancer.The breast journal · 2026Article
- Differences in patient-centered burdens and economic outcomes based on sociodemographic characteristics and social determinants of health: a scoping review.Frontiers in public health · 2026Article
- Medicaid Expansion Is Associated with Lower Mortality in Patients with Locally Advanced Breast Cancer.Annals of surgical oncology · 2025Article
- Social Needs in Cancer Survivors: A Scoping Review and Future Directions.Current oncology reports · 2025Article
- Non-monetary burdens of out-of-pocket costs incurred by patients and caregivers for medical care: a scoping review.BMJ open · 2025Article
- Racial discrimination among women seeking breast cancer care.NPJ breast cancer · 2025Article
- Financial Toxicity in Older Adults With Cancer and Their Caregivers.JCO oncology practice · 2025Review
- See Me, Hear Me: Racial Discrimination Among Women Seeking Breast Cancer Care.Research square · 2024Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
purposeDisparities in breast cancer treatment for low-income and minority women are well documented. We examined economic hardship, health literacy, and numeracy and whether these factors were associated with differences in receipt of recommended treatment among breast cancer survivors.
methodsDuring 2018-2020, we surveyed adult women diagnosed with stage I-III breast cancer between 2013 and 2017 and received care at three centers in Boston and New York. We inquired about treatment receipt and treatment decision-making. We used Chi-squared and Fisher's exact tests to examine associations between financial strain, health literacy, numeracy (using validated measures), and treatment receipt by race and ethnicity.
resultsThe 296 participants studied were 60.1% Non-Hispanic (NH) White, 25.0% NH Black, and 14.9% Hispanic; NH Black and Hispanic women had lower health literacy and numeracy and reported more financial concerns. Overall, 21 (7.1%) women declined at least one component of recommended therapy, without differences by race and ethnicity. Those not initiating recommended treatment(s) reported more worry about paying large medical bills (52.4% vs. 27.1%), worse household finances since diagnosis (42.9% vs. 22.2%), and more uninsurance before diagnosis (9.5% vs. 1.5%); all P < .05. No differences in treatment receipt by health literacy or numeracy were observed.
conclusionIn this diverse population of breast cancer survivors, rates of treatment initiation were high. Worry about paying medical bills and financial strain were frequent, especially among non-White participants. Although we observed associations of financial strain with treatment initiation, because few women declined treatments, understanding the scope of impact is limited. Our results highlight the importance of assessments of resource needs and allocation of support for breast cancer survivors. Novelty of this work includes the granular measures of financial strain and inclusion of health literacy and numeracy.
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