Cancer Res Treat.  2022 Jul;54(3):834-841. 10.4143/crt.2021.784.

Validation of Korean Version of the COmprehensive Score for financial Toxicity (COST) Among Breast Cancer Survivors

• Shim S
• Kang D
• Kim N
• Han G
• Lim J
• Kim H
• Park J
• Lee M
• Lee JE
• Kim SW
• Yu J
• Chae BJ
• Ryu JM
• Nam SJ
• Lee SK
• Cho J

• KMID: 2531329
• DOI: http://doi.org/10.4143/crt.2021.784

Abstract

Purpose
Little is known about the impact of financial toxicity in disease-free breast cancer survivors. We aim to validate the COmprehensive Score for financial Toxicity in Korean (COST-K) and evaluate financial toxicity among disease-free breast cancer survivors.
Materials and Methods
We conducted linguistic validation following a standardized methodology recommended by Functional Assessment of Chronic Illness Therapy multilingual translation (FACITtrans). For psychometric validation, we conducted a cross-sectional survey with 4,297 disease-free breast cancer survivors at a tertiary hospital in Seoul, Korea between November 2018 and April 2019. Survivors were asked to complete the COST-K and European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30) questionnaires. The test-retest reliability, internal consistency, and validity of the COST-K were assessed using standard scale construction techniques.
Results
The COST-K demonstrated good internal consistency, with a Cronbach’s α of 0.81. The test-retest analysis revealed an intraclass correlation coefficient of 0.78. The COST-K had moderate correlation (r=–0.60) with the financial difficulty item of the EORTC QLQ-C30 and week correlation with the items on acute and chronic symptom burdens (nausea/vomiting, –0.18; constipation, –0.14; diarrhea, –0.14), showing good convergent and divergent validity. The median COST-K was 27 (range, 0 to 44; mean±standard deivation [SD], 27.1±7.5) and about 30% and 5% of cancer survivors experienced mild and severe financial toxicity, respectively. Younger age, lower education, lower household income was associated with higher financial toxicity.
Conclusion
The COST-K is a valid and reliable instrument for measuring financial toxicity in disease-free breast cancer survivors. Considering its impact on the health-related quality of life, more studies need to be conducted to evaluate financial toxicity in cancer survivors and design interventions.

Keyword

Financial stress; Quality of life; Breast neoplasms; Cancer survivors; Validation study

Figure

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  Fig. 1 Scree plot of eigenvalues after exploratory factor analysis.

Reference

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