Socioeconomic impact among and socioeconomic support services for adolescents and young adults with cancer: A European perspective

Abstract

Adolescent and young adult (AYA) cancer patients (15-39 years at initial cancer diagnosis) have distinct needs setting them apart from other age groups. Research shows that the socioeconomic impact (SEI) of cancer is more severe for AYAs than for older adults, and that employment and financial outcomes of AYAs are significantly different from matched peers without cancer, both on the short- and long-term. This study examines the SEI of cancer on AYAs and the availability and characteristics of socioeconomic support systems in 11 European countries. Two survey studies explored the SEI of cancer among AYAs and the support systems available in Europe. The SEC study (N = 3157) is a cross-sectional European study exploring the SEI of cancer from the patient's perspective. In this study, a sub-analysis has been conducted on the AYAs. Additionally, a survey targeting healthcare providers (HCPs) was conducted to contextualize the SEC-AYA data and identify local and national support systems. The first survey study included 577 AYAs, of which 75% reported financial difficulties and 65% experienced income loss. Seventy percent of AYAs made efforts to increase financial resources, such as using savings or borrowing money, to cover treatment-related expenses. Forty percent of AYAs faced challenges in obtaining financial services, like mortgages. Among 41 participating HCPs, 54% routinely discussed financial difficulties, yet 68% were unaware of AYAs' financial challenges. Available services for treatment-related income loss, work reintegration, and financial services are often not AYA-specific. European AYAs with cancer face significant SEI challenges, highlighting the need for targeted socioeconomic support and national guidelines tailored to AYAs. Future research should focus on establishing AYA-specific services and policies to improve outcomes for AYAs with cancer.

Keywords: AYAs; adolescents and young adults; oncology; socioeconomic impact.

FIGURE 1

Socioeconomic impact of a cancer diagnosis among AYAs: Discuss financial difficulties (A), Employment changes (B) and income loss (C). In Figure 1A, answers from the “Other” category identified mainly physiotherapists, psychologists, and pharmacists as additional HCPs patients discussed their financial difficulties with. Figure 1B has not been adjusted for purchasing power parity (PPP), but the median monthly earning per capita was added for context. Abbreviations of countries: BE, Belgium; BG, Bulgaria; CH, Switzerland; CY, Cyprus; DE, Germany; DK, Denmark; ES, Spain; FI, Finland; FR, France; NL, Netherlands; NO, Norway.

FIGURE 2

Socioeconomic impact of a cancer diagnosis among AYAs: Additional treatment‐related expenses (A), Financial coping behavior (B) and Difficulties in access to financial services (C). *Multiple answers per patient possible. Answers of the “Additional expenses” category in Figure 2A included physiotherapy, wigs, nutritional supplements, and prosthesis; Answers of the “Other services” category in Figure 2C included insurance related to funerals, disability, income, and pension; Abbreviations of countries: BE, Belgium; BG, Bulgaria; CH, Switzerland; CY, Cyprus; DE, Germany; DK, Denmark; ES, Spain; FI, Finland; FR, France; NL, Netherlands; NO, Norway.