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

Cancer. 2013 Oct 15;119(20):3710-7. doi: 10.1002/cncr.28262. Epub 2013 Jul 31.


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.

Keywords: access to care; cancer; financial burden; health disparities; survivors.

MeSH terms

  • Adult
  • Aged
  • Delivery of Health Care / economics
  • Female
  • Follow-Up Studies
  • Health Expenditures*
  • Health Services Accessibility / economics
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / economics*
  • Neoplasms / psychology
  • Neoplasms / therapy
  • Patient Preference*
  • Prognosis
  • Survivors / psychology*
  • Withholding Treatment / statistics & numerical data*