A study evaluating the economic impact of the cancer in young women has found that the diagnosis can result in employment disruption and financial decline. The findings—published by Tangka et al in Cancer Epidemiology, Biomarkers & Prevention—indicate the need for obtaining and maintaining comprehensive health insurance coverage.
Although breast cancer in young adults is rare, the American Cancer Society estimates that in 2019, 58,330 women aged 49 and younger were diagnosed with the disease. Compared to older women, younger women are often diagnosed with more aggressive breast cancers and have lower survival rates, according to the Young Survival Coalition.
Study Methodology
The researchers surveyed 830 women under the age of 40 diagnosed with breast cancer between January 2013 and December 2014. The cross-sectional survey was fielded in 2017 and included questions on demographics; insurance status; employment; out-of-pocket costs associated with diagnosis, such as copayments, hospital bills, deductibles, and medication costs, as well as indirect medical costs not covered by insurance; and financial well-being.
The researchers evaluated the association between the respondents’ characteristics at diagnosis and financial decline using logistic regression.
Study Findings
KEY POINTS
- Nearly half of the women surveyed experienced financial decline due to costs associated with their breast cancer care.
- Despite having health insurance coverage, many young women diagnosed with breast cancer experience financial hardship during the course of treatment.
The researchers found that although 92.5% of the respondents were continuously insured over the past 12 months, 9.5% 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.
Overall, 47% experienced financial decline due to treatment-related costs. To pay for their out-of-pocket costs of care, 81.5% of the women used personal funds; 22.9% borrowed from family or friends; 22.7% left some medical bills unpaid; 21.7% increased their credit card debt; and 18.2% postponed paying bills. Patients with some college education, multiple comorbidities, late-stage diagnoses, and self-funded insurance were most vulnerable.
“The breast cancer diagnosis created financial hardship for half of the respondents and led to myriad challenges in maintaining employment. Employment decisions were heavily influenced by the need to maintain health insurance coverage,” concluded the study authors.
Understanding the Costs of Care
Florence K.L. Tangka, PhD, MS
A greater understanding of the costs of cancer care could help inform patient’s treatment decisions, according to lead study author Florence K.L. Tangka, PhD, MS, a health economist in the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention. “A lot of women don’t have a good sense of how much a cancer diagnosis will cost, including out-of-pocket costs,” she explained in a statement. “We feel that that if they have cost information, they can develop better financial plans to cover their treatment expenses.”
Dr. Tangka is the corresponding author of this study.
Disclosure: Funding for this study was provided by the Centers for Disease Control and Prevention. For full disclosures of the study authors, visit cebp.aacr.journals.org.
