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.

Financial Burden of Cancer Clinical Trial Participation and the Impact of a Cancer Care Equity Program

“…Compared with non-CCEP participants, those enrolled in the CCEP were younger and had lower incomes. Studies have shown that, in general, younger patients and those with lower incomes experience considerable cancer-related financial problems [24,[48][49][50][51]. We also found that a higher proportion of CCEP participants were enrolled in phase I clinical trials and had metastatic disease.…”

The personal financial burden of complications after colorectal cancer surgery

“…11,12 Second, personal finances are recognized as an important factor in patients' ability to receive optimal therapy for cancer. 34 Anywhere from 9% to 20% of cancer patients report missing essential medical care because of personal cost, 12,35,36 and the likelihood of economically-motivated nonadherence is even greater among cancer patients who are younger, 35 have the lowest incomes, 12 or are uninsured. 36 Furthermore, disease-related job loss and disability substantially increase nonadherence with recommended cancer therapy.…”

Process of allogeneic hematopoietic cell transplantation decision making for older adults

“…Concern about medical cost precipitated harmful health behaviors in one-third of the study population; those who were retired were more likely to exhibit treatment noncompliance due to financial reasons. In their study of 1556 cancer survivors, Kent et al 29 concluded that those who reported cancer-related financial problems were more likely to report delaying medical care (18.1 vs 7.4%; P o 0.0001) or forgoing medical care (13.5 vs 5.1%; P o0.0001) and prescription medications (13.8 vs 7.7%; P = 0.001) than those without financial problems. 29 Arora et al 30 found that patients with low income were over three times as likely to report frailty after transplant.…”

“…In their study of 1556 cancer survivors, Kent et al 29 concluded that those who reported cancer-related financial problems were more likely to report delaying medical care (18.1 vs 7.4%; P o 0.0001) or forgoing medical care (13.5 vs 5.1%; P o0.0001) and prescription medications (13.8 vs 7.7%; P = 0.001) than those without financial problems. 29 Arora et al 30 found that patients with low income were over three times as likely to report frailty after transplant. 23 Therefore, financial stress negatively impacts patients' long-term health and ongoing treatment decisions.…”