Financial Burden of Cancer Survivors

Health and quality of life negatively affected

March 28, 2016--An analysis of US data from 2011 indicates that nearly 29 percent of cancer survivors are financially burdened as a result of their cancer diagnosis and/or treatment.

Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study also reveals that such hardships can have lasting physical and mental effects on cancer survivors.

Few studies have assessed the impact of cancer-related financial burden on cancer survivors' quality of life. To investigate, Hrishikesh Kale, MS, and Norman Carroll, PhD, of Virginia Commonwealth University School of Pharmacy, analyzed 2011 Medical Expenditure Panel Survey data on 19.6 million cancer survivors.

They considered financial burden to be present if one of the following problems was reported: borrowed money/declared bankruptcy, worried about paying large medical bills, unable to cover the cost of medical care visits, or other financial sacrifices.

The researchers found that nearly 29 percent of US cancer survivors reported at least one financial problem resulting from cancer diagnosis, treatment, or lasting effects of that treatment.

Of all cancer survivors in the analysis, 21 percent worried about paying large medical bills, 11.5 percent were unable to cover the cost of medical care visits, 7.6 percent reported borrowing money or going into debt, 1.5 percent declared bankruptcy, and 8.6 percent reported other financial sacrifices.

Cancer survivors who faced such financial difficulties had lower physical and mental health-related quality of life, higher risk for depressed mood and psychological distress, and were more likely to worry about cancer recurrence compared with cancer survivors who did not face financial problems.

Also, as the number of financial problems reported by cancer survivors increased, their quality of life continued to decrease and their risk for depressed mood, psychological distress, and worries about cancer recurrence continued to increase.

The investigators also identified the effects of different types of financial problems on quality of life: declaring bankruptcy was associated with a 20 percent to 25 percent reduction in quality of life, while worrying about paying large medical bills was associated with a reduction of 6 percent to 8 percent.

"Our results suggest that policies and practices that minimize cancer patients' out-of-pocket costs can improve survivors' health-related quality of life and psychological health," said Dr. Carroll.

"Reducing the financial burden of cancer care requires integrated efforts, and the study findings are useful for survivorship care programs, oncologists, payers, pharmaceutical companies, and patients and their family members."

Mr. Kale noted that oncologists should consider selecting treatments that are less expensive but similar in effectiveness, discuss treatment costs with patients, and involve patients in making decisions about their therapy.

"Also, cancer patients and family members should educate themselves regarding survivorship issues, coverage and benefit design of their health plans, and organizations that provide financial assistance. Cancer survivorship care programs can identify survivors with the greatest financial burden and focus on helping them cope with psychological stress, anxiety, and depression throughout their journey with cancer."

Financial Burden of Cancer Survivorship Varies by Age, Cancer Site

Study calls for targeted efforts to address excess costs faced by those with a history of cancer

Newswise, February 13, 2016--Survivors of cancer pay thousands of dollars in excess medical expenditures every year, with the excess financial burden varying by age and cancer site, according to a study by the American Cancer Society study. 

The study, appearing in the Journal of the National Cancer Institute, says targeted efforts will be important to reduce the economic burden of cancer.

As a group, cancer survivors (estimated to number 14.5 million in the United States in 2014) face greater economic burden, including medical expenditures and productivity losses. But relatively little is known about whether that burden varies by cancer site compared to similar individuals without a cancer history.

Researchers led by Zhiyuan 'Jason' Zheng, PhD, senior health services researcher in the Surveillance and Health Services Research program at the American Cancer Society, used 2008 to 2012 Medical Expenditure Panel Survey data to measure excess economic burden attributable to the three most prevalent cancers. 

They calculated excess annual medical expenditures and productivity losses (employment disability, missed work days, and days stayed in bed) for colorectal (n = 540), female breast (n = 1568), and prostate (n = 1170) cancer survivors, and for those without a cancer history (n = 109,423). 

They stratified the data by cancer site and age (nonelderly: 18-64 years vs elderly: ?65 years), and controlled for age, sex, race/ethnicity, marital status, education, number of comorbidities, and geographic region.

They found cancer survivors experienced annual excess medical expenditures compared with individuals without a cancer history. 

For the nonelderly population, annual excess expenditures were $8657 for colorectal cancer; $5119 for breast cancer; and $3586 for prostate cancer. For the elderly population, annual excess expenditures were: colorectal: $4913; breast: $2288; prostate: $3524.

Nonelderly colorectal and breast cancer survivors were more likely to have employment disability as well as productivity loss at work (7.2 days) and at home (4.5 days). In contrast, elderly survivors of all three cancer sites had comparable productivity losses as those without a cancer history.

"This study helps us quantify the excess economic burden associated with the three major cancer sites," said Dr. Zheng. 

"Understanding this burden is an important step to shape health care policies to target areas where cancer survivors are most vulnerable."

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Article: Annual Medical Expenditure and Productivity Loss Among Colorectal, Female Breast, and Prostate Cancer Survivors in the United States JNCI J Natl Cancer Inst (2016) 108 (5): djv382 doi: 10.1093/jnci/djv382