Survivors of Childhood Cancer More Likely to Experience Financial Burden

Many survivors of childhood cancer face financial hardships after moving into adulthood, according to a recent study published in the Journal of Clinical Oncology.

Data was gathered from the Childhood Cancer Study and an age-stratified random sample of 580 survivors of childhood cancer was compared with a control group of 173 siblings of cancer survivors. The survivors were more likely to have out of pocket medical costs that added up to be 10 percent or more of their annual household income.

“Previously, little research had addressed the long-term financial burden experienced by survivors of childhood cancer,” Ryan Nipp, M.D., M.P.H, instructor of Medicine at Massachusetts General Hospital and author on the study said in an interview with CURE. “In the present analysis, we sought to evaluate financial burden due to medical costs among childhood cancer survivors and a sibling comparison group and to identify the relationship between high out-of-pocket medical costs and the adverse consequences of financial burden.”

Those who had a higher percent of their income spent on health care were more likely to have been unemployed, hospitalized within the past year and/or have household incomes under $50,000, according to the study. This not only affects survivors’ financial situations, but also may have negative implications on their health. Survivors experiencing this financial burden were found to be more likely to defer care for a medical problem or skip tests, treatments or follow-up appointments. This group was also more likely to have thoughts of filing for bankruptcy.

Survivors delaying going to the doctor could be particularly costly for this population, as survivors of childhood cancer are more likely than the general population to have chronic health complications that are related to their previous cancer or treatment. These conditions require long-term care.

“Collectively, these findings demonstrate that survivors’ out-of-pocket medical costs put them at risk for experiencing adverse effects related to financial burden, underscoring the need to address high out-of-pocket medical expenditures in this population,” Nipp said, noting that many survivors of childhood cancer also encounter difficulties in finding adequate health insurance.

Nipp emphasized that this research is a crucial first step in addressing the financial hardships that survivors face.

“Our findings have important policy implications,” he said. “Childhood cancer survivors represent a population with pre-existing health conditions at particularly high-risk for financial burden, which can negatively influence health outcomes, especially as cost sharing increases.”

More research on the extent to which survivors experience greater financial burden is due, Nipp said. There is a need for a systematic understanding of the financial concerns that this population experiences — starting earlier on with conversations between patients and their health care providers.

“Future efforts to address the financial burden of cancer survivors should investigate the efficacy of incorporating financial discussions within survivorship clinics and/or care plans and focus on developing programs involving financial services, patient navigators and/or social work,” Nipp said.