Cancer Survivors, Especially Younger Ones, Frequently Face Medical Financial Hardship and Financial Sacrifices

A new study found that medical financial hardship and financial sacrifices pose a significant burden on cancer survivors, notably in younger survivors.

The analysis included financial data on 963 cancer survivors from the 2016 Medical Expenditures Panel Survey – Experiences with Cancer. Medical financial hardship attributable to cancer was determined in three domains: material, psychological, and behavioral. Factors such as changes in spending and use of savings were considered nonmedical financial sacrifices.

The study was published in Cancer Epidemiology, Biomarkers, & Prevention.

“As the number of cancer survivors grows, the costs of cancer treatments rise, and patient cost-sharing increases, there is a growing need for financial intervention at multiple levels to help cancer survivors minimize their risk of financial hardship,” said study author Xuesong Han, PhD, senior principal scientist in Health Services Research at the American Cancer Society, in a press release.

Financial Outcomes Differ by Age

When analyzing cancer survivors aged between 18 and 64 years, more than half (53.6%) reported at least one domain of hardship, while 28.4% and 11.4% reported two or all three domains of hardship, respectively. Survivors aged 65 years and older were less likely to report at least one domain of hardship (42.0%) or all three domains of hardship (4.0%) but were slightly more likely to report two domains of hardship (12.7%). The younger survivor cohort was also more likely to sustain financial sacrifices attributable to cancer than survivors aged 65 years and older (54.2% vs. 38.4%; P<0.001). These factors corresponded with hardship intensity (most were also correlated with financial sacrifices):

• Low income and educational attainment
• Racial/ethnic minority
• Comorbidity
• Lack of private insurance coverage
• Extended employment change
• Recent cancer treatment

“Overall, health insurance coverage is critically important for cancer patients and survivors,” said Dr. Han. “Even those who had private insurance coverage reported financial hardship, suggesting that the types of coverage and extent of patient cost-sharing are important too.”

“Provisions of the Affordable Care Act that have expanded insurance coverage options, such as the Medicaid expansion, have been associated with reductions in financial hardship among cancer survivors in other studies,” he added. “Employers can play a large role in mitigating hardship through flexible workplace accommodations such as availability of paid and unpaid sick leave, and supportive programs for both survivors and family members.”