Nearly 45% of Cancer Survivors Report Financial Struggle

TOPLINE:

Nearly 45% of cancer survivors face financial hardship during and after their cancer care, with factors including higher social vulnerability, younger age, lower income, and advanced cancer stage contributing to this strain, according to a recent study.

METHODOLOGY:

• Cancer survivors experience significant economic challenges during and after their cancer treatment, and this financial hardship can compromise treatment adherence, quality of life, and survival. Still, the impact community- and individual-level factors, such as social vulnerabilities, education level, or income, have on patients’ experience of financial hardship remains unclear.
• Researchers used data from the 2021 Health Information National Trends Survey — Surveillance, Epidemiology, and End Results to elucidate associations between financial difficulties among cancer survivors and a range of individual- and community-level factors.
• The analysis included 1212 survey respondents (median age, 72 years) representing over 400,000 cancer survivors.
• The primary outcome was patient-reported experience of cancer-related financial hardship, categorized as “not at all”, “a little”, “some”, or “a lot”. The analysis factored in social vulnerability, as measured by the Social Vulnerability Index, which includes 16 measures of socioeconomic, demographic, and housing/transportation vulnerabilities. Index scores range from 0 to 1, with 0 being the least vulnerable and 1 being the most vulnerable.
• Overall, 59.1% had completed college, 56.5% had an annual household income exceeding $75,000, 70.5% had private or employer-based health insurance, and 67.8% had localized cancer.

TAKEAWAY:

• Overall, almost 45% of cancer survivors experienced some degree of financial hardship — with 22.1% reporting “a little,” 15.0% “some,” and 6.5% “a lot” of it, while 56.4% of participants reported no hardship.
• Younger age (50-59 years; adjusted odds ratio [aOR], 3.66), lower income ($35,000-$74,999; aOR, 3.55), advanced cancer stage (aOR, 1.92), higher social vulnerability (aOR, 1.80), and having Medicare insurance (aOR, 1.43) were associated with higher odds of experiencing financial hardship.
• The level of financial hardship varied by cancer type. Patients with melanoma or male reproductive cancers reported the least financial hardship, while those with bone and soft tissue cancers, certain hematologic malignancies (myelodysplastic and myeloid), and gastrointestinal cancers reported higher levels.
• In the population, the median social vulnerability index score was 0.41. An increase in the Social Vulnerability Index of just 0.01 was associated with a greater likelihood of reporting some level of hardship.

IN PRACTICE:

“Although policy efforts to curb the costs of cancer care are essential, acknowledging the role of community and structural barriers and identifying socially vulnerable populations for targeted interventions represent a potential strategy toward mitigating financial hardship and delivering equitable cancer care,” the authors concluded.

SOURCE:

The study, led by Apoorv Dhir, MD, from the University of Michigan, Ann Arbor, Michigan, was published online in JAMA Network Open.

LIMITATIONS:

The study design did not allow for determining causal relationships. Selection bias and sampling method limited ability to generalize the findings. Potential inaccuracies in patient-reported information and possible unmeasured factors could have affected the results.

DISCLOSURES:

The study was supported by a grant from the National Cancer Institute. No relevant conflicts of interest were disclosed by the authors.

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