Are survivors who report cancer-related financial problems more likely to forgo or delay medical care?

Authors

  • Erin E. Kent PhD,

    Corresponding author
    1. Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
    • Corresponding author: Erin E. Kent, PhD, Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr, MSC 9762, Bethesda, MD 20892-9762; Fax: (240) 276-7906; E-mail: Erin.Kent@nih.gov

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  • Laura P. Forsythe PhD, MPH,

    1. Patient-Centered Outcomes Research Institute, Washington, DC
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  • K. Robin Yabroff PhD,

    1. Health Services and Economics Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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  • Kathryn E. Weaver PhD, MPH,

    1. Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
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  • Janet S. de Moor PhD, MPH,

    1. Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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  • Juan L. Rodriguez PhD,

    1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Julia H. Rowland PhD

    1. Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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  • The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the National Cancer Institute, the Centers for Disease Control and Prevention, or the Patient-Centered Outcomes Research Institute.

Abstract

BACKGROUND

Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care.

METHODS

The authors identified cancer survivors diagnosed as adults (n = 1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented.

RESULTS

Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%-34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all P < .05).

CONCLUSIONS

Cancer-related financial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer. Cancer 2013;119:3710–3717. © 2013 American Cancer Society.

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