Dental Treatment Discontinuation for Financial Reasons Among Patients with Cancer: A Cross-Sectional Study with Non-Cancer Controls

TL;DR

This study found that cancer patients are less likely than non-cancer controls to stop dental treatment due to financial reasons, though younger cancer patients with poor oral health and financial strain are more affected.

Contribution

The study is the first to compare dental treatment discontinuation for financial reasons between cancer patients and non-cancer controls in Japan.

Findings

Dental treatment discontinuation for financial reasons occurred in 3.4% of cancer patients and 5.8% of controls, though the difference was not statistically significant.

Cancer patients who discontinued treatment were younger, had worse oral health-related quality of life, and higher financial toxicity.

Physical and psychological barriers were frequently reported by cancer patients who discontinued dental treatment.

Abstract

Background/Objectives: The extent to which patients with cancer discontinue dental treatment for financial reasons remains unclear. This study compared the prevalence of financially driven dental treatment discontinuation between patients with cancer and without cancer (controls) and identified factors associated with discontinuation among patients with cancer. Methods: This cross-sectional, questionnaire-based survey conducted in November 2024 comprised 500 patients who had one of five common cancers in Japan and 500 non-cancer participants allocated to reflect the cancer group age distributions, sex, and household income. Only patients who received cancer treatment within the past 5 years and had a family dental clinic were included. Discontinuation was assessed from self-reported dental treatment cessation for economic reasons. Univariate analyses were employed for group comparisons (p < 0.05). Results: Dental treatment discontinuation for financial reasons occurred in 3.4% (95% CI 2.1–5.4%) of patients with cancer and 5.8% (95% CI 4.1–8.2%) of controls (p = 0.096). Among the patients with cancer, those who discontinued were younger (58.8 vs. 66.1 years, p = 0.010) and frequently reported physical or psychological barriers to dental care and discontinuation being financially driven (all p < 0.001). They also had poor oral health-related quality of life (Oral Health Impact Profile-14: 17.4 vs. 7.8, p < 0.001) and greater financial toxicity (Comprehensive Score for Financial Toxicity: 24.6 vs. 29.3, p = 0.001). Conclusions: Oral health-related quality of life was lower among participants reporting dental treatment discontinuation. Early identification of financial barriers and support may warrant further study.