Closing the financial toxicity gap for adolescents and young adults with cancer

Kaul, Sanjana; Kirchhoff, Anne C.

doi:10.1002/pbc.27742

Cited by 9 publications

(12 citation statements)

References 18 publications

(35 reference statements)

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“…90,91 At the same time, AYAs may face additional financial strains not experienced by older patients with cancer, such as the costs of oncofertility services, which are often not covered by insurance. 92,93 As a result, financial concerns are common among AYAs with cancer and are often left unaddressed. In the AYA Hope study, financial advice was the most commonly reported unmet need by AYAs.…”

Section: Financial Toxicity: An Unaddressed Side Effect For Ayas Withmentioning

confidence: 99%

“…At the same time, due to their unique life stage, AYAs with cancer may face greater structural vulnerabilities or social risk that affects their access to care, treatment adherence, and financial toxicity, such as housing instability, food insecurity, and educational barriers (e.g., student loans). 92 As such, screening AYAs for social and economic determinants in the oncology context should encompass resource needs (e.g., childcare costs, student debt) extending beyond insurance and medical costs. 103 Screening for social and economic determinants of health may allow oncology clinicians to reduce barriers to care.…”

Section: Financial Toxicity: An Unaddressed Side Effect For Ayas Withmentioning

confidence: 99%

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Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship

Perez

Salsman

Fladeboe

et al. 2020

American Society of Clinical Oncology Educational Book

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Research on adolescents and young adults (AYAs) with cancer has flourished over the past decade, underscoring the unique medical and psychosocial needs of this vulnerable group. A cancer diagnosis during adolescence and young adulthood intersects with the developmental trajectory of AYAs, derailing critical physical, social, and emotional development. AYAs face these abrupt life changes needing age-appropriate information and resources to offset these challenges. Greater attention is needed to address AYA-specific concerns on reproductive and sexual health, financial security and independence, emotional well-being, social support, and end-of-life care. If these unique needs are unaddressed, this can adversely affect AYAs’ health care engagement and overall quality of life, increasing their risk for cancer-related morbidity and early mortality. In particular, health care decisions made during treatment have important implications for AYA patients’ future health. Oncology clinicians are well positioned to address AYA patients’ concerns by anticipating and addressing the challenges this age group is likely to face. In this paper, we explore several core topics that affect AYAs’ quality of life and that can be challenging to address. Starting from the moment of diagnosis, through cancer treatment and post-treatment survivorship, and into end of life, each section highlights critical developmental-centric life domains that are affected by the cancer experience. Specifically, we discuss resources, tools, and strategies to navigate these challenging conversations. Taking a risk-reduction approach that invites two-way communication and facilitates referral to age-appropriate resources would help destigmatize these experiences and, in turn, would support the provision of compassionate and effective age-concordant care to this vulnerable group.

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Section: Financial Toxicity: An Unaddressed Side Effect For Ayas Withmentioning

confidence: 99%

Section: Financial Toxicity: An Unaddressed Side Effect For Ayas Withmentioning

confidence: 99%

Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship

Perez

Salsman

Fladeboe

et al. 2020

American Society of Clinical Oncology Educational Book

Self Cite

View full text Add to dashboard Cite

show abstract

“…Since being applied to cancer populations in 2009 4 and then illuminated in 2013, 5 financial toxicity has been used in reference to financial burden experienced by individuals with chronic illnesses and their caregivers. However, we have not yet captured the breadth of the phenomenon, its consequences, and effective ways of mitigating this problem for cancer survivors and their families and/or caregivers at various phases across the illness trajectory 5,6 …”

Section: The Concept Of Financial Toxicitymentioning

confidence: 99%

Financial Toxicity in Adolescents and Young Adults With Cancer

et al. 2021

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Background A cancer diagnosis as an adolescent and young adult (AYA) poses exceptional challenges, including potential greater financial toxicity than older survivors experience who have had more time for career establishment and to build financial assets. Costs to patients have increased more than the past decade; prospects for AYA long-term survival have also increased. A better understanding of what financial toxicity is, how it presents, and the immediate and longer-term implications for AYAs is needed. Objective The aim of this study was to analyze the concept financial toxicity in AYAs diagnosed with cancer. Methods We used Rodgers’ evolutionary method and articles published between January 2013 and December 2020. Results We identified key antecedents, attributes, and consequences of financial toxicity in AYAs and review its related terms that have often been used as surrogate terms. Attributes were financial burden, financial distress, and competing financial pressures. Consequences were mostly adverse and persistent and included engaging in various financial problem-solving behaviors, material hardship and poor financial well-being, and deteriorated quality of life. Conclusions Results of this analysis clarify financial toxicity and provide guidance for a conceptual framework in the context of AYA cancer survivorship. Its consequences in AYAs with cancer are profound and will continue to evolve over time with changes in health systems and the economy. Implications for Practice Oncology nurses should understand the attributes and consequences of financial toxicity for AYAs throughout the cancer trajectory. Future research on financial toxicity should extend across AYAs living with other chronic illnesses and cancer survivors in other age groups.

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“…27 Although research has examined the impact of insurance coverage on cancer diagnosis, treatment, and overall survival, very little is known about how changes in insurance coverage affect cancer survivors, particularly young survivors who are most at-risk as many transition out of their parents' coverage as they approach 27 years of age. 28 The primary objective of this study was to characterize change in insurance coverage among CCS from diagnosis to survivorship and describe patient factors associated with these changes. To fully understand the impact of insurance changes, the secondary objective was to understand whether these changes in coverage and other patient factors impacted patient-reported utilization of cancer-related followup care.…”

Section: Introductionmentioning

confidence: 99%

Insurance coverage change and survivorship care among young adult survivors of childhood cancer

Mobley

Kim

Cousineau

et al. 2021

Health Services Research

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Objective: To (1) characterize change in type of insurance coverage among childhood cancer survivors from diagnosis to survivorship and (2) examine whether insurance change is associated with cancer-related follow-up care utilization. Data Sources: Participants in this study were derived from the Project Forward study, a population-based, observational study of childhood cancer survivors in Los Angeles County that used California Cancer Registry data to identify participants. Study Design: Multivariable logistic regression models incorporating survey nonresponse weights estimated the change in the marginal predicted probabilities of insurance change and survivorship care, adjusting for demographic, socioeconomic, and clinical covariates and clustering by treating hospital.

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Closing the financial toxicity gap for adolescents and young adults with cancer

Cited by 9 publications

References 18 publications

Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship

Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship

Financial Toxicity in Adolescents and Young Adults With Cancer

Insurance coverage change and survivorship care among young adult survivors of childhood cancer

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