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Material and Psychological Financial Hardship for U.S. Cancer Patients

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Key Points

  • Patients aged 18 to 64 years were more likely to report material financial hardship associated with cancer and its treatment, according to the results of a population-based study in the United States.
  • Patients aged 18 to 64 years were more likely to report psychological financial hardship.

In a population-based study reported in the Journal of Clinical Oncology, Yabroff et al found that cancer and its treatment were associated with material financial hardship for 29% and psychological financial hardship for 32% of patients aged 18 to 64 years in the United States. Financial hardship was less common among older patients.

Study Details

The study involved data on 1,202 adult cancer survivors (565 aged 18 to 64 years, 637 aged ≥ 65 years) from the 2011 Medical Expenditure Panel Survey Experiences With Cancer questionnaire. Material financial hardship was defined as ever borrowing money or going into debt, filing for bankruptcy, being unable to cover one’s share of medical care costs, or making other financial sacrifices because of cancer, its treatment, and the lasting effects of treatment. Psychological financial hardship was defined as ever worrying about paying large medical bills.

Financial Hardship

Material financial hardship (28.4% vs 13.8%, P < .001) and psychological financial hardship (31.9% vs 14.7%, P < .001) were more common in cancer survivors aged 18 to 64 years than those aged ≥ 65 years.

In adjusted analyses, younger age (P = .009), female sex (P = .0340,) race other than white (P = .006), change in employment due to cancer (P < .001), and more recent treatment (P = .014) were associated with a greater likelihood of material financial hardship among patients aged 18 to 64 years; younger age (P = .012) was associated with a greater likelihood among those aged ≥ 65 years, with a trend toward a greater likelihood for race other than white (P = .052).

Factors significantly associated with psychological financial hardship were lower family income (P = .019), lack of insurance (P = .043), and more recent treatment (P = .024) among those aged 18 to 64 years and younger age (P < .001) among those aged ≥ 65 years.

The investigators concluded: “Cancer survivors, especially the working-age population, commonly experience material and psychological financial hardship.”

K. Robin Yabroff, PhD, of the National Cancer Institute, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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