Financial toxicity status and influencing factors in 1,108 nasopharyngeal carcinoma patients: A cross-sectional study

Background About half of patients with nasopharyngeal carcinoma (NPC) occurs in China. The treatment process generates high costs and imposes a heavy financial burden on NPC patients. This study aim to investigate the current situation of financial toxicity in NPC patients and analyze its influencing factors. Methods This study followed STROBE guidelines. From February 2024 to December 2024, the researcher investigated 1,108 NPC patients by convenience sampling at a tertiary Class A tumor hospital in Guangdong Province, China, in terms of general information, anxiety, and depression. Binary logistic regression analysis was used to explore the related factors affecting the financial toxicity of NPC patients. Results The total average score of financial toxicity in 1,108 NPC patients was (21.81 ± 0.26), and the incidence of financial toxicity was 64.71%. The average score of the Generalized Anxiety Disorder-7 was (4.78 ± 0.14), and the incidence rate was 47.11%. The average score of Patient Health Questionnaire-9 was (6.60 ± 0.16), and the incidence rate was 60.56%. The stepwise logistic regression analysis showed that anxiety (OR = 1.063, 95% CI: 1.008–1.120, P  = 0.024), depression (OR = 1.145, 95% CI: 1.091–1.202, P  < 0.001), recurrence of NPC (OR = 1.925, 95% CI: 1.061–3.491, P  = 0.031), smoking history (OR = 1.509, 95% CI: 1.088–12.093, P  = 0.014), and rural area (OR = 1.632, 95% CI: 1.154–2.307, P  = 0.006) were risk factors for financial toxicity in NPC patients. Age (OR = 0.985, 95% CI: 0.972–0.999, P  = 0.04), intensity-modulated radiotherapy (OR = 0.667, 95% CI: 0.495–0.899, P  = 0.008), personal monthly income between 5,001–10,000 yuan (OR = 0.241, 95% CI: 0.161–0.363, P  < 0.001), and > 10,001 yuan (OR = 0. 099, 95%CI: 0.058–0.168, P  < 0.001) were the protective factor of financial toxicity, and the correct prediction rate of the model was 75.36%. Conclusions Financial toxicity is common in patients with NPC, and is significantly positively correlated with anxiety and depression. Medical staff should evaluate anxiety and depression to manage the risk of financial toxicity in NPC patients, improving the support network at individual, family and social levels for high-risk groups.