Objectives & Purpose
This study examined the influence of socioeconomic status (SES) on the physical and psychological wellbeing of cancer patients and symptom changes over treatment course, to identify health inequities during the cancer care continuum.
Sample & Setting
A secondary dataset of 240 cancer patients aged 20–90 years in New Delhi, India, from the International Psycho-Oncology Society, was utilised. All participants completed a baseline survey (T1); 120 were followed up after approximately one month (T2).
Procedures
Chi-Squared and linear regressions were run to assess the relationship between self-reported income and educational attainment and both physical–pain, weakness, nausea and drowsiness–and psychological–depression, anxiety, feeling informed, resolution of personal/financial concerns (RPFC)–symptoms. Symptom change scores (T2 minus T1) were also calculated to assess this relationship over the treatment course.
Results
Patients who reported 'not coping' on income were more likely to report weakness at T1 (p<0.001), pain at T2 (p = 0.038), anxiety at both timepoints (p=0.026; p=0.020), and feeling uninformed at T1 (p=0.018). Reported post-secondary education was associated with lower severity physical symptoms at T2, less deterioration in weakness symptoms between T1 and T2 (p=0.042), and feeling more informed at T1 (p=0.025). In regression, higher combined income and education predicted lower pain (p=0.024) and weakness (p<0.001) at T1, and better RPFC at T2 (p=0.028). Higher income also predicted feeling more informed at T1 (B=0.224, 95% CI: 0.075 to 0.374, p=0.003), reduced anxiety at T2 (B=-0.304, 95% CI: -0.585 to -0.023, p=0.035), and increased RPFC over the course of care (B=-0.187, 95% CI: -0.370 to -0.004, p=0.045).
Conclusion & Implications
Higher-SES was generally associated with reduced symptom burden, feeling better informed and greater RPFC during care. This highlights the need for a more holistic approach to cancer care–financial accessibility, patient education, and psychological support–that acknowledges additional burdens placed on low-SES patients.