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One-quarter of breast cancer survivors reported financial decline after treatment
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Four years after receiving treatment for breast cancer, 25% of survivors reported they were worse off financially, due in part to their treatment.
Additionally, 12% of survivors indicated they still had medical debt from their treatment.
“As oncologists, we are proud of the advances in our ability to cure an increasing proportion of patients diagnosed with breast cancer,” Reshma Jagsi, MD, DPhil, associate professor of radiation oncology at the University of Michigan Medical School, said in a press release. “But as treatments improve, we must ensure that we do not leave these patients in financial ruin because of our efforts.”
Reshma Jagsi
To evaluate the financial experiences of a cohort of long-term breast cancer survivors, Jagsi and colleagues surveyed 3,133 women with nonmetastatic breast cancer approximately 9 months after their diagnosis and again 4 years later.
The researchers assessed self-reported out-of-pocket medical expenses, how patients financed these expenses, patient perceptions of their financial status and the privations they experienced in the broader economic environment.
The researchers applied multivariable models to correlates of self-reported decline in financial status attributed to breast cancer and having experienced at least one type of privation, such as economically motivated treatment nonadherence and broader hardships related to medical expenses.
The 1,502 patients who responded to both surveys reported a median $2,000 in out-of-pocket expenses. Seventeen percent of responders reported spending $5,000, and an additional 12% reported having medical debt 4 years post-diagnosis.
Debt varied significantly by race: 9% of whites, 15% of blacks, 17% of English-speaking Latinas and 10% of Spanish-speaking Latinas reported debt (P=.03).
Researchers noted that 25% of women experienced financial decline at least partly attributed to breast cancer; Spanish-speaking Latinas had significantly increased odds of this decline relative to whites (OR=2.76; P=.006).
Other factors that made a woman more susceptible to these hardships included age younger than 65 years, household income less than $50,000, part-time work at diagnosis, reduced work hours after diagnosis, lack of substantial prescription drug coverage, breast cancer recurrence and receipt of chemotherapy.
At least one privation was experienced by 18% of the sample; blacks (OR=2.6; P<.001) and English-speaking Latinas (OR=2.2; P=.02) were significantly more likely to have experienced privation than whites.
“These patients are particularly vulnerable to financial distress,” Jagsi said. “We need to ensure appropriate communication between patients and their doctors regarding the financial implications of a cancer diagnosis and treatment decisions to help reduce this long-term burden.”