The social and economic toll of cancer survivorship: a complex web of financial sacrifice

• Type of Material: Article
• Authors: Matthew P. Banegas, Kaiser Permanente; Jennifer L. Schneider, Kaiser Permanente; Alison J. Firemark, Kaiser Permanente; John F. Dickerson, Kaiser Permanente; Erin E. Kent, National Cancer Institute; Janet S. de Moor, National Cancer Institute; Katherine S Virgo, Emory University; Gery P. Guy, Centers for Disease Control and Prevention; Donatus U. Ekwueme, Centers for Disease Control and Prevention; Zhiyuan Zheng, American Cancer Society; Alexandra M. Varga, Kaiser Permanente; Lisa A. Waiwaiole, Kaiser Permanente; Stephanie M. Nutt, University of Texas Austin; Aditi Narayan, LIVESTRONG Foundation; K. Robin Yabroff, American Cancer Society
• Language: English
• Date: 2019-06-01
• Publisher: Springer (part of Springer Nature): Springer Open Choice Hybrid Journals
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019, Springer Science+Business Media, LLC, part of Springer Nature.
• Final Published Version (URL): http://dx.doi.org/10.1007/s11764-019-00761-1
• Title of Journal or Parent Work: Journal of Cancer Survivorship
• ISSN: 1932-2259
• Volume: 13
• Issue: 3
• Start Page: 406
• End Page: 417
• Grant/Funding Information: This study was funded, in part, by the Kaiser Permanente Center for Health Research.
• Keywords: HARDSHIP; Social and economic needs; Social Sciences, Biomedical; HEALTH; Science & Technology; BURDEN; COLORECTAL-CANCER; Biomedical Social Sciences; STRESS; Oncology; OF-POCKET COSTS; DISTRESS; Access to care; Life Sciences & Biomedicine; UNITED-STATES; ANTICANCER MEDICATIONS; STRAIN; Financial hardship; Cancer survivors; Social Sciences; Medical debt
• Research Categories: Health Sciences, Public Health; Health Sciences, Health Care Management; Health Sciences, Oncology

Abstract

Purpose: To assess the financial outcomes and associated social and economic effects on cancer survivors and their families. Methods: We assessed the responses of 1656 cancer survivors to a survey with both closed- and open-ended questions about cancer-related financial sacrifices they and their family experienced and evaluated differences in financial sacrifice by reported levels of cancer-related debt. Results: The most commonly reported financial sacrifices included cutbacks on household budgets, challenges with health care insurance and costs, career/self-advancement constraints, reduction/depletion of assets, and inability to pay bills. Survivors who incurred $10,000 or more in debt were significantly more likely to report social and economic impacts, including housing concerns and strained relationships. Conclusions: Our analysis demonstrates both the frequency with which cancer survivors and families must make financial sacrifices as a result of their cancer, and the variety of forms that this sacrifice can take, even for individuals who have health insurance. The many types of financial hardship create challenges that are unique to each survivor and family. Implications for Cancer Survivors: Interventions that allow for personalized assistance with the specific financial and social needs of cancer survivors and their families have the potential to address a critical aspect of the long-term wellbeing of this important population.