How Many Young Breast Cancer Survivors Struggle Financially?

TOPLINE:

About 1 in 6 young adults with breast cancer experienced a moderate to severe degree of financial difficulty that persisted into early survivorship, with Hispanic ethnicity, higher body mass index (BMI), unemployment, and arm symptoms significantly increasing the risk.

METHODOLOGY:

• Young adults with breast cancer often present with advanced disease or aggressive tumor types, which can contribute to higher medical costs that ultimately lead to financial distress. However, the prevalence and specific factors contributing to financial toxicity in young breast cancer survivors are not well characterized.
• To evaluate the prevalence and patterns of financial hardship, researchers evaluated 1008 young adults aged 40 years or younger with stage 0-III breast cancer who were enrolled in the Young Women’s Breast Cancer Study. Overall, 87.7% were White, 6% Asian, 4.7% Hispanic, and 3.5% Black individuals.
• Participants provided data on employment status, treatment type, and arm symptoms, assessed using validated tools and surveys.
• The primary outcome was perceived financial difficulty, measured using the Cancer Rehabilitation Evaluation System survey with a 5-point Likert scale (0 indicating “not at all”; 4 indicating “extremely”). Responses were tracked from baseline through 10 years post-diagnosis.
• Overall, 39.6% of patients were employed at baseline and at 1 year, and 35.4% were not employed at either timepoint. Most patients had stage I or II tumors; 70.5% underwent mastectomy, and 71.5% reported either arm swelling or limited range of motion on the affected side within 2 years of surgery.

TAKEAWAY:

• Three distinct financial trajectories emerged: 54.7% of participants experienced minimal (little to no) financial difficulty, 29.1% reported mild difficulty that improved over time, and 16.3% experienced moderate to severe difficulty that peaked several years post-diagnosis.
• Hispanic ethnicity (odds ratio [OR], 3.71), unemployment (OR, 2.66), BMI ≥ 25 (OR, 2.59), bilateral mastectomy (OR, 2.00), and arm symptoms (OR, 1.77) were associated with an increased likelihood of experiencing financial difficulties.
• Patients who had a college degree (OR, 0.20) or were partnered (OR, 0.24) were more likely to experience low financial difficulty.
• Overall, 80% women reported no financial difficulty at 10 years, and, for most, the prevalence of perceived financial difficulty decreased as more time from cancer diagnosis passed.

IN PRACTICE:

“In this cohort study of young adults with breast cancer, we identified a subset of patients who experienced a high degree of financial difficulty that persisted into early survivorship,” the authors concluded. “Our findings contribute significantly to understanding the experiences of young breast cancer survivors and have important implications for future interventions aimed at improving patient-centered outcomes.”

SOURCE:

This study, led by Sara P. Myers, MD, PhD, Brigham and Women’s Hospital, Boston, was published online in JAMA Network Open.

LIMITATIONS:

The homogeneous cohort composition, particularly regarding race, ethnicity, and level of educational attainment, limited the generalizability of the study. Premorbid treatment-related adverse events were not captured and could have influenced long-term financial outcomes. Additionally, the reliance on self-reported arm symptoms could have overestimated the prevalence of clinically significant arm morbidity.

DISCLOSURES:

No funding information was provided for the study. Several authors reported receiving grants or research funding and having other ties with various sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.