Report says about 25% of cancer survivors face financial hardship

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In the United States, about a quarter of cancer survivors report having difficulty paying their health care bills and about a third are worried about medical costs, according to the report published in the US journal Morbidity and Mortality Weekly Centers for Disease Control and Prevention. Report Thursday.

The report found that cancer survivors spent a lot more money each year than people who never had cancer.

"The economic burden … will probably increase"

"The population of cancer survivors is increasing and many are struggling to bear the costs of medical care," said Donatus Ekwueme, health economist at CDC Atlanta, the report's lead author.

"As a result, some survivors are afraid to pay and have problems paying for medical care, and some are even forced to go bankrupt," he said.

An estimated 16.9 million cancer survivors in the United States.

"The number of Americans with a history of cancer is expected to increase over the next decade, and the economic burden associated with living with a cancer diagnosis will likely also increase," researchers wrote in the report.

For the report, researchers from the CDC, the American Cancer Society and the National Cancer Institute analyzed data on annual expenditures and financial hardship faced by cancer survivors aged 18 to 64 in the United States. United between 2011 and 2016.

These data, which come from self-reported information from questionnaires, come from the panel survey on medical expenses.

The researchers found that the average annual spending of cancer survivors was about $ 1,000, compared to $ 622 for people without a history of cancer.

The data also showed that among cancer survivors, 25.3% reported suffering from physical difficulties associated with cancer. This translates into borrowing, debt or bankruptcy to cover medical expenses, for example. It also showed that 34.3% of those surveyed said they had psychological financial difficulties, considered as a concern about medical bills, according to the report.

The report had some limitations, including the fact that the cancer diagnostic data was self-reported and did not include information on the stage of cancer or the types of treatment received by some of the survivors.

"It seems to be this gift that continues to give"

Ultimately, cancer patients are more likely to actively seek health care even after surviving the disease, said Dr. Rachel Adams Greenup, a breast cancer surgeon and health services researcher at the University of Ottawa. Duke University School of Medicine in Durham, North Carolina. not involved in the report, but conducted separate studies on the costs of cancer treatment and health care.
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"Asking someone to follow their active cancer treatment does not free them from the financial hardships of treatment, which seems to be the gift that continues to give," Greenup said.

"Cancer survivors, even if they are cured, have more frequent contact with the health care system, so it's more expensive for them and for the health care system than someone who does not." Has never had cancer, "she said. "It's devastating for these patients."

One way to help avoid future financial difficulties for cancer patients is to discuss these costs before starting treatment, Greenup said. In 2009,
The American Society of Clinical Oncology even published guidelines in 2009 that showed that physicians play an important role in managing and discussing the direct costs of cancer care with their patients.

"The data is slowly accumulating the fact that the cost discussions are actually probably very beneficial," she said.

When insurance did not pay, parents funded a $ 95,000 life-saving treatment for the cancer patient
Overall, it is "not surprising" that cancer patients often face financial difficulties even after receiving treatment and surviving the disease, said Dr. Georges Benjamin, Executive Director of the World Health Organization. American Public Health Association in Washington, which did not participate in the report.

"Far too many people, even with health insurance, are still struggling to pay their bills because of the costs of health care," said Benjamin.

"We also know that there is a correlation between the costs of health care and the mental health of people," he said. Even though the diagnosis of cancer has also been associated with an increased risk of sadness and depression, "we know how much the inability to pay health care bills causes more sadness, more depression, and the concerns of the real ones. challenge. "

From a public health perspective, "the best way to cope with cancer and cancer costs is to prevent or contract the disease at an early stage, so that the diagnosis is at an early stage of the disease. diagnosis, which makes the treatment easier and less expensive., "says Benjamin.

What is needed to solve the problem of the cost of cancer

Stephanie Wheeler, a health services researcher and decision researcher at the Gillings Global School of Public Health at the University of North Carolina, Chapel Hill, also has some disparities in the challenges financial costs related to health care costs. involved in the report.
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"Some subgroups, such as people of color, have also experienced greater material and psychosocial financial hardship, which is worrisome given their risk of lower overall cancer outcomes," Wheeler said.

"For under-served populations facing the greatest cost-related challenges – including people of color, low-income, working-age adults, and uninsured people – an inability to meet the costs Cancer care will likely worsen disparities in existing results, "he said. "Until significant policy reforms are implemented at the national level to contain the costs of health care and to take into account for-profit incentives that generate a diversity of actors, most local strategies will be fragmentary and insufficient – such as, for example, giving aspirin to a cancer patient, long-term relief, but will not solve the underlying problem. "

Efforts to reduce the financial burden of cancer patients "are urgently needed," said Dr. Ryan Nipp, a gastrointestinal oncologist and health services researcher at Massachusetts General Hospital in Boston, who said: Did not participate in the report, but conducted his own research on the costs of cancer care.

"The financial burden of cancer has been shown to be linked to poor quality of life, high symptom burden, and even survival," Nipp said, adding that more research on the impact of cancer is needed. cost discussions, as well as screening for the potential financial burden, could help.

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