{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T06:12:56Z","timestamp":1773123176510,"version":"3.50.1"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000982","name":"Conquer Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000982","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Financial hardship from cancer care is associated with poor patient outcomes. Economic disruption during the COVID-19 pandemic may have exacerbated patients\u2019 financial concerns. We explore how social deprivation index (SDI), clinical, and treatment-related factors impacted financial hardship in this observational secondary analysis using data collected prospectively during implementation of financial hardship screening from our NCI-designated center during COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Adults aged \u226518 years undergoing active treatment for stage 0-IV breast or lung cancer and who completed a 5-point Likert response-item screening for financial difficulty between 11\/2020 and 11\/2021 were included. Generalized estimating equations assessed associations between quartiles of zip-code level SDI, a composite obtained using data from US Census and American Community Survey, and binary outcome of financial hardship adjusting for relevant covariates\n                      <jats:italic>.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2245 patients, 87% identified as White, 9% as Black, 2% as Asian. The majority of patients identified as non-Hispanic (99%). Median age was 62 years old (IQR 53\u201371).The majority were treated for breast cancer (79%). Significant financial hardship (Likert responses \u22652) was reported by 7%. Most were married, had managed-care insurance, resided in urban settings, and had early-stage cancers (all p\u2009&lt;\u20090.001). Of those included, 83% received surgery, 52% received chemotherapy, and 65% received radiation. Compared to the lowest SDI quartile, penultimate and highest quartiles were associated with financial hardship (Q3 aOR 1.86; 95%CI 1.13\u20133.05); Q4 aOR 2.05; 95%CI 1.15\u20133.63). Younger age, Black race, comorbidities, radiation, and chemotherapy were also associated with greater financial hardship (p\u2009&lt;\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, greater SDI, younger age, Black race, comorbidities, receipt of radiation and\/or chemotherapy were associated with financial hardship. These factors may guide focused screening of vulnerable populations to assist with equitable access to resources that offset the economic effects of cancer care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0342984","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T17:23:28Z","timestamp":1773077008000},"page":"e0342984","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors correlated with financial hardship among cancer patients during the COVID-19 pandemic"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4318-3938","authenticated-orcid":true,"given":"Sara P.","family":"Myers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"Tsung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4356-5522","authenticated-orcid":true,"given":"J. 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