Are survivors who report cancer-related financial problems more likely to forgo or delay medical care?

Abstract

Background: Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care.

Methods: The authors identified cancer survivors diagnosed as adults (n=1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented.

Results: Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%-34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all P<.05).

Conclusions: Cancer-related financial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer.

Keywords: access to care; cancer; financial burden; health disparities; survivors.

Figure 1

The percentage of survivors reporting forgoing or delaying care because of cost who also reported that cancer caused them financial problems is shown, adjusted for other covariates (age at last cancer diagnosis; sex; marital status; race/ethnicity; education; whether insurance paid for cancer treatment; residential region; recurrence or multiple cancer history; years since last cancer diagnosis; history of surgery, chemotherapy, or radiation; and number of comorbidities). Only survivors who reported not receiving cancer care within the previous 12 months (n = 1276) were included. *P < .05.