Many Young Women With Breast Cancer Face Financial Hardship, Make Employment Decisions Based on Diagnosis

A study published in Cancer Epidemiology, Biomarkers & Prevention found that a breast cancer diagnosis in young women creates a financial hardship, leading to employment decisions that are heavily influenced by the need to maintain health insurance coverage.

Researchers recruited 830 women less than 40 years of age who were diagnosed with breast cancer between January 2013 and December 2014. Patients were identified via California, Florida, Georgia, and North Carolina population-based cancer registries. Patients completed a cross-sectional survey in 2017 that included questions on demographics, insurance, employment, out-of-pocket costs, and financial well-being.

Cost and employment concerns

Nearly all respondents (92.5%) were continuously insured over the past 12 months, but 9.5% reportedly paid a “higher price than expected” for coverage. Common concerns among the 73.4% of respondents who were employed at diagnosis included increased paid (55.1%) or unpaid (47.3%) time off, suffering job performance (23.2%), and staying at (30.2%) or avoiding changing (23.5%) jobs for health insurance purposes.

Nearly half of participants (47%) experienced financial decline due to treatment-related costs. Patients who were most vulnerable to this were those with some college education, multiple comorbidities, late-stage diagnoses, and self-funded insurance.

A total of 27.7% of patients spent less than $500 in out-of-pocket costs, while 27.9% spent $500 to $2,000, 18.7% spent $2,001 to $5,000, and 17.0% spent $5,001 to $10,000. To pay for this, 81.5% of women used personal funds, 22.9% borrowed from family or friends, 22.7% left some medical bills unpaid, 21.7% increased credit card debt, and 18.2% postponed paying bills.

The authors noted that while employment benefits varied, programs like paid sick leave, flexible scheduling, disability leave, and telecommuting may help women maintain their employment status.