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. 2016 Jan 20;34(3):259-67.
doi: 10.1200/JCO.2015.62.0468. Epub 2015 Dec 7.

Financial Hardship Associated With Cancer in the United States: Findings From a Population-Based Sample of Adult Cancer Survivors

K Robin Yabroff  1 , Emily C Dowling  2 , Gery P Guy Jr  2 , Matthew P Banegas  2 , Amy Davidoff  2 , Xuesong Han  2 , Katherine S Virgo  2 , Timothy S McNeel  2 , Neetu Chawla  2 , Danielle Blanch-Hartigan  2 , Erin E Kent  2 , Chunyu Li  2 , Juan L Rodriguez  2 , Janet S de Moor  2 , Zhiyuan Zheng  2 , Ahmedin Jemal  2 , Donatus U Ekwueme  2
Affiliations

Financial Hardship Associated With Cancer in the United States: Findings From a Population-Based Sample of Adult Cancer Survivors

K Robin Yabroff et al. J Clin Oncol. .

Abstract

Purpose: To estimate the prevalence of financial hardship associated with cancer in the United States and identify characteristics of cancer survivors associated with financial hardship.

Methods: We identified 1,202 adult cancer survivors diagnosed or treated at ≥ 18 years of age from the 2011 Medical Expenditure Panel Survey Experiences With Cancer questionnaire. Material financial hardship was measured by ever (1) borrowing money or going into debt, (2) filing for bankruptcy, (3) being unable to cover one's share of medical care costs, or (4) making other financial sacrifices because of cancer, its treatment, and lasting effects of treatment. Psychological financial hardship was measured as ever worrying about paying large medical bills. We examined factors associated with any material or psychological financial hardship using separate multivariable logistic regression models stratified by age group (18 to 64 and ≥ 65 years).

Results: Material financial hardship was more common in cancer survivors age 18 to 64 years than in those ≥ 65 years of age (28.4% v 13.8%; P < .001), as was psychological financial hardship (31.9% v 14.7%, P < .001). In adjusted analyses, cancer survivors age 18 to 64 years who were younger, female, nonwhite, and treated more recently and who had changed employment because of cancer were significantly more likely to report any material financial hardship. Cancer survivors who were uninsured, had lower family income, and were treated more recently were more likely to report psychological financial hardship. Among cancer survivors ≥ 65 years of age, those who were younger were more likely to report any financial hardship.

Conclusion: Cancer survivors, especially the working-age population, commonly experience material and psychological financial hardship.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest are found in the article online at www.jco.org. Author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
(A) Any material financial hardship associated with cancer by age group and type of health insurance. (B) Psychological financial hardship associated with cancer, by age group and type of health insurance. Data from the 2011 Medical Expenditure Panel Survey Experiences With Cancer Survey.
Fig 2.
Fig 2.
Material and psychological financial hardship associated with cancer.
See this image and copyright information in PMC

Comment in

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