Partners of patients with colorectal cancer (CRC) experience serious long-term financial toxicity that associates with worse health-related quality of life (HRQOL), according to a study published in JAMA Network Open.

Researchers conducted a mixed-methods surveys to gauge long-term financial toxicity and its association with HRQOL among CRC survivors and their partners.

They identified 986 patients with stage III CRC between the ages of 21 years and 85 years who were eligible for their study, 501 of whom returned their survey. Of those who responded, 428 reported having a partner. Surveys were returned by 311 (72.6%) partners. Four partner surveys did not have a corresponding patient survey resulting a total of 307 patient-partner dyads. Among the partners, 56.1% were younger than 65 years, 62.6% were women, and 85.7% were White.

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Three intermediate financial toxicity outcomes in the partners were assessed: financial worry, debt, and financial burden. Financial worry and debt were measured by single questions on the survey. Financial burden was measured with the Personal Financial Burden Scale. The researchers also used the PROMIS-29+2 Profile, version 2.1, to measure HRQOL.

More than half (62.9%) of the partners reported financial burden, with 35.5% reporting high financial worry and 28.6% reporting debt. As evidenced by prior research, younger partners of patients with CRC were “significantly more likely to report financial burden and debt.”

From their research, the researchers learned that partners cited contributing systemic factors such as high costs, health insurance challenges, multiple bills from different providers, lost work or wages, and insurance and healthcare systems that were often “daunting.” The partners also described individual-level factors such as disruption to social relationships when they asked for financial support for medications, living costs, and medical supplies, as well as “uncharacteristic spending” as a coping mechanism.

“The results of this survey study suggest that long term FT [financial toxicity] among partners of CRC survivors was associated with worse HRQOL via systems- and individual-level behavioral factors,” the research team concluded. “Our findings provide an understanding of the association between FT and specific domains of partner HRQOL. This contribution to the FT literature will help researchers better tailor interventions to effectively mitigate FT and improve HRQOL for both partners and patients.”


Ghazal LV, Abrahamse P, Ward KC, Morris AM, Hawley ST, Veenstra CM. Financial toxicity and its association with health-related quality of life among partners of colorectal cancer survivors. JAMA Netw Open. 2023;6(4):e235897. doi:10.1001/jamanetworkopen.2023.5897