{"doi":"10.1093/jnci/djab210","title":"S1417CD: A Prospective Multicenter Cooperative Group-Led Study of Financial Hardship in Metastatic Colorectal Cancer Patients","abstract":"BACKGROUND: Financial toxicity is a growing problem in oncology, but no prior studies have prospectively measured the financial impact of cancer treatment in a diverse national cohort of newly diagnosed cancer patients. S1417CD was the first cooperative group-led multicenter prospective cohort study to evaluate financial hardship in metastatic colorectal cancer (mCRC) patients. METHODS: Patients aged 18 years or older within 120 days of mCRC diagnosis completed quarterly questionnaires for 12 months. We estimated the cumulative incidence of major financial hardship (MFH), defined as 1 or more of increased debt, new loans from family and/or friends, selling or refinancing home, or 20% or more income decline. We evaluated the association between patient characteristics and MFH using multivariate cox regression and the association between MFH and quality of life using linear regression. RESULTS: A total of 380 patients (median age = 59.9 years) were enrolled; 77.7% were White, 98.0% insured, and 56.5% had annual income of $50 000 or less. Cumulative incidence of MFH at 12 months was 71.3% (95% confidence interval = 65.7% to 76.1%). Age, race, marital status, and income (split at $50 000 per year) were not statistically significantly associated with MFH. However, income less than $100 000 and total assets less than $100 000 were both associated with greater MFH. MFH at 3 months was associated with decreased social functioning and quality of life at 6 months. CONCLUSIONS: Nearly 3 out of 4 mCRC patients experienced MFH despite access to health insurance. These findings underscore the need for clinic and policy solutions that protect cancer patients from financial harm.","journal":"JNCI Journal of the National Cancer Institute","year":2021,"id":153303,"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":70,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6135,"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":274181,"name":"Joseph M. Unger","orcid":"0000-0002-5191-0317","position":1,"is_corresponding":false},{"id":559110,"name":"Amy K. Darke","orcid":"0000-0002-9821-2065","position":2,"is_corresponding":false},{"id":559111,"name":"Jennifer M. Suga","orcid":"0009-0005-9560-7511","position":3,"is_corresponding":false},{"id":278316,"name":"James L. Wade","orcid":"0000-0002-3802-3860","position":4,"is_corresponding":false},{"id":559884,"name":"Peter J. Kourlas","orcid":null,"position":5,"is_corresponding":false},{"id":559885,"name":"Sreenivasa R Chandana","orcid":null,"position":6,"is_corresponding":false},{"id":465849,"name":"Mark Allen O’Rourke","orcid":"0000-0003-1707-6186","position":7,"is_corresponding":false},{"id":559886,"name":"Suma Satti","orcid":null,"position":8,"is_corresponding":false},{"id":559112,"name":"Diane Liggett","orcid":"0000-0001-8616-3609","position":9,"is_corresponding":false},{"id":107125,"name":"Dawn L. Hershman","orcid":"0000-0001-8807-153X","position":10,"is_corresponding":false},{"id":355457,"name":"Scott D. Ramsey","orcid":"0000-0001-5972-8280","position":11,"is_corresponding":false},{"id":389881,"name":"Veena Shankaran","orcid":"0000-0001-8136-6140","position":0,"is_corresponding":true}],"reference_count":26,"raw_metadata":null,"created_at":"2026-07-18T23:43:39.820288Z","pmid":"34981117","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":[]}