Estimating The Health And Economic Burden Of Cancer Among Those Diagnosed As Adolescents And Young Adults

Abstract

Adolescent and young adult cancer survivors—those who were ages 15–39 at their first cancer diagnosis—have important health limitations. These survivors are at risk for higher health care expenditures and lost productivity, compared to adults without a history of cancer. Using Medical Expenditure Panel Survey data, we present nationally representative estimates of the economic burden among people who were diagnosed with cancer in adolescence or young adulthood. Our findings demonstrate that surviving cancer at this age is associated with a substantial economic burden. Compared to adults without a history of cancer, adolescent and young adult cancer survivors had excess annual medical expenditures of $3,170 per person and excess annual productivity losses of $2,250 per person. Multifaceted prevention strategies, including education and sustained intervention programs to ensure access to lifelong risk-based follow-up care, may be effective ways to improve the economic outcomes associated with cancer survivorship in this population.

Predictors of financial difficulties and work modifications among cancer survivors in the United States

“…Our results are consistent with prior reports showing that cancer survivors face productivity losses and heavy financial burdens as a result of their disease and related treatment [3, 4, 6, 8–13, 18, 19]. Previous estimates of the proportion of cancer survivors with financial distress have ranged from 14–78 % [12].…”

“…Many previous studies of financial and work-related burden in cancer survivors have limited generalizability given small, focused samples in single institutions or among those with a specific type of cancer [3, 6, 9, 14]. Previous population-based studies have generally analyzed expenditures and are limited in their ability to account for indirect costs and other factors that impact the overall financial burden on cancer survivors or use very broad measures of perceived financial burden rather than specific measures such as debt or bankruptcy [4, 5, 8, 11, 16, 18, 19]. A recent systematic review of studies on cancer-related financial distress identified only four US studies reporting the prevalence of financial distress among adult cancer survivors, most of which were conducted at single institutions and focused on subgroups of cancer survivors [12].…”

US trends in survival disparities among adolescents and young adults with non-Hodgkin lymphoma

“…Adolescents and young adults face unique challenges that accompany their cancer diagnosis, including a lack of life experience and resources juxtaposed with the recent independence that accompanies young adulthood [34]. They may face increased financial burden [35] and challenges obtaining or maintaining health insurance [36]. Furthermore, a recent study reported that uninsured young adult cancer patients were more likely to present with metastatic disease and have higher all-cause mortality [37].…”

Adolescent and Young Adult Cancer Survival

“…While brain and central nervous system (CNS) cancers affect pediatric, AYA, and adult populations, proportions of the histological subtypes are often different between older and younger patient groups with pilocytic astrocytomas more common in pediatric populations, and glioblastomas more common with increasing age (1). There are many explanations for cancer survival differences in the AYA age group, including suggestions that the biology of breast and colon cancer may be different in AYAs (6), access to care (8,9), participation in clinical trials and whether the treatments are directed at children or adult populations (6,10), contrasting improvement in outcomes compared with younger and older patients (11), economic (12) and psychosocial issues (13).…”