Women Under 40 may Face Financial Distress After Breast Cancer Diagnosis

A breast cancer diagnosis in women younger than 40 may result in disruptions in employment and job-related decisions, as well as a decrease in finances, according to data published in Cancer Epidemiology, Biomarkers & Prevention.

“A lot of women don’t have a good sense of how much a cancer diagnosis will cost, including out-of- pocket costs,” study author Dr. Florence K.L. Tangka, a health economist in the division of cancer prevention and control at the Centers for Disease Control and Prevention (CDC), said in a press release. “We feel that if they have cost information, they can develop better financial plans to cover their treatment expenses.”

The goal of this study was to review the insurance, employment and financial experiences of younger women with breast cancer and to assess factors that were linked to possible financial decline.

The study included 830 women who received a breast cancer diagnosis between the ages of 18 and 39 from January 2013 to December 2014. The study population was identified through state cancer registries in California, Florida, Georgia and North Carolina.

A survey was distributed to the patients and it asked questions about insurance status, including any changes in coverage; any out-of-pocket costs related to care; employment status and work-related benefits; and access to treatment and quality of care.

Most of the survey respondents (71.3%) reported receiving insurance continuously through the same plan for the 12 months prior to the survey. An additional 21.2% of the respondents had insurance coverage but switched plans during the year, and 5.8% of the respondents reported being uninsured for any duration prior to the survey.

Overall, 73.4% of respondents were employed at the time of diagnosis. More than half (55.1%) reported having access to paid sick leave, 49.4% had access to a flexible schedule, 40.5% had access to disability, 36.8% received unpaid sick leave and 21.5% were able to work remotely.

Almost half of the women (47%) experienced financial decline as a result of the costs of their cancer care. All respondents experienced some form of financial impact that was a result of them having to spend money out-of-pocket for treatment costs and other nonclinical costs during the time period before the survey. Of note, 27.7% of the women had spent less than $500; 27.9% spent between $500 and $2,000; 18.7% spent $2,001 and $5,000; and 17% had spent between $5,001 and $10,000.

Many of the women (81.5%) had to use personal funds to pay for the out-of-pocket costs; 22.9% borrowed money from family or friends; 22.7% left some medical bills unpaid; 21.7% increased their credit card debt and 18.2% delayed paying other bills.

Additionally, some respondents (30.2%) decided to stay in a job or avoided changing jobs (23.5%) to keep their health insurance.

Tangka noted that the results could help remind clinicians to consider financial concerns when discussing possible treatment options.

“Even though patients and physicians understand the importance of having discussions about the economic burden of cancer, such conversations seldom occur,” she said in the release. “Cancer patients may not have choices in all aspects of cancer care, but if they have information on the duration of treatment and how much they need to pay out of pocket, they can plan better.”