Abstract 4217: Consumer credit, cancer treatment, and health among women with a history of breast cancer

Background: Breast cancer treatment may represent an economic shock that may be influenced by, or may influence a cancer survivor’s socio-economic position (SEP). Financial toxicity or economic burden due to cancer treatment and treatment’s adverse effects may be reflected in one’s consumer credit ratings; however, credit’s contribution to individual health for cancer survivors or those managing long-term adverse effects of cancer treatment has not been evaluated. This analysis examined associations between self-rated health outcomes of women with a history of breast cancer, type of cancer treatment, and presence of breast cancer-related lymphedema, a persistent adverse effect of treatment, and consumer credit rating. Methods: From May to September 2015, 129 women from Pennsylvania and New Jersey were enrolled in the PAL Social and Economic Quality of Life cross-sectional study. All participants had a history of breast cancer, and completed a survey of: demographics, SEP, co-morbidities, SF-12 self-rated health, psychosocial stress, adjuvant cancer treatments (chemotherapy, hormone therapy, radiation), breast cancer-related lymphedema symptoms, and credit quality (5-point scale self-reported as poor to excellent). Multivariable linear regression measured the association between credit and health. Results: Mean respondent age was 64, with 38.2% reporting excellent and 37.4% reporting very good/good credit. Participants completed cancer treatment on average 11.5 years ago. After adjusting for demographics and SEP, good credit was associated with a 4.5 (p=0.009) point increase in composite physical health t-score and -1.13 (p=0.02) decrease in psychosocial stress compared to women with poor credit, but was not associated with type of cancer treatment or lymphedema. Conclusion: While credit was associated with self-rated health for women with an average 11.5 year history of breast cancer, current credit quality did not appear to be associated with type of cancer treatment previously received or with the presence of lymphedema, a persistent adverse effect of cancer treatment. It is still possible that cancer treatment may have influenced credit close to time of treatment, and credit was able to rebound since that time. Future work should test causal pathways between credit and health outcomes after cancer diagnosis. Citation Format: Lorraine T. Dean, Kathryn H. Schmitz, Kevin Frick, Lauren Nicholas, Yuehan Zhang, SV Subramanian, Kala Visvanathan. Consumer credit, cancer treatment, and health among women with a history of breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4217. doi:10.1158/1538-7445.AM2017-4217