{"doi":"10.1002/hed.26801","title":"The cost of cure: Examining objective and subjective financial toxicity in head and neck cancer survivors","abstract":"BACKGROUND: Little is documented regarding objective financial metrics and their impact on subjective financial toxicity in head and neck cancer (HNC) survivors. METHODS: In a cross-sectional analysis, 71 survivors with available claims data for HNC-specific out-of-pocket expenses (OOPE) completed a survey including patient-reported, subjective financial toxicity outcome tools: the Comprehensive Score for financial Toxicity (COST) and the Financial Distress Questionnaire (FDQ). RESULTS: Worse COST scores were significantly associated with lower earnings at survey administration (coefficient = 3.79; 95% CI 2.63-4.95; p < 0.001); loss of earnings after diagnosis (coefficient = 6.03; 95% CI 0.53-11.52; p = 0.032); and greater annual OOPE as a proportion of earnings [log10(Annual OOPE:Earnings at survey): coefficient = -5.66; 95% CI -10.28 to -1.04; p = 0.017]. Similar results were found with FDQ. CONCLUSION: Financial toxicity is associated with particular socioeconomic characteristics which, if understood, would assist the development of pre-treatment screening tools to detect at-risk individuals and intervene early in the HNC cancer survivorship trajectory.","journal":"Head & Neck","year":2021,"id":158840,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":44,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9418,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":668346,"name":"Mark A. Fadel","orcid":"0000-0002-8648-9366","position":1,"is_corresponding":false},{"id":668347,"name":"Meng Zhao","orcid":"0000-0001-8267-9245","position":2,"is_corresponding":false},{"id":668849,"name":"Michael Corcoran","orcid":null,"position":3,"is_corresponding":false},{"id":668348,"name":"Maryanna S. Owoc","orcid":"0000-0002-3755-1071","position":4,"is_corresponding":false},{"id":668349,"name":"Teresa Hagan Thomas","orcid":"0000-0001-7403-7314","position":5,"is_corresponding":false},{"id":350794,"name":"Lindsay M. Sabik","orcid":"0000-0002-0613-4929","position":6,"is_corresponding":false},{"id":557790,"name":"Marci L. Nilsen","orcid":"0000-0002-5888-668X","position":7,"is_corresponding":false},{"id":109277,"name":"Robert L. Ferris","orcid":"0000-0001-6605-2071","position":8,"is_corresponding":false},{"id":398046,"name":"Leila J. Mady","orcid":"0000-0002-2682-3297","position":9,"is_corresponding":false},{"id":668345,"name":"Khalil Baddour","orcid":"0000-0002-4362-0782","position":0,"is_corresponding":true}],"reference_count":50,"raw_metadata":null,"created_at":"2026-07-18T23:44:30.791367Z","pmid":"34235804","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}