Treatment Costs Extra Hard for Young Colon Cancer Patients

Although nearly four out of ten stage III colon cancer patients had serious financial problems during treatment, treatment related expenses were particularly hard on patients under fifty.  After taking all factors into account, young patients were more than fifty times times more likely to experience financial hardship than patients over 75.  Treatment costs drove them to:

  • be in debt
  • have to borrow money from family or friends
  • sell or refinance their homes
  • experience a more than 20 percent drop in income

Financial difficulties sometimes led to stopping treatment early despite the fact that nearly all patients had insurance. 5.4 percent skipped treatments and 7.2 percent refused treatment altogether because of financial problems. Young patients were nearly nine times more likely to skip or refuse treatments.

Patients with incomes under $30,000 were six times more likely not to get recommended treatment. Not being able to work because of disability, leave of absence or employment also raised risk of not getting treatment.

Researchers sent questionnaires to 555 stage III colon cancer patients treated in Washington State between January 1, 2008 and March 1, 2010, identified through Cancer Surveillance System, asking them about the financial impact of their cancer treatment. Over half returned the surveys.

Serious financial hardships reported by all patients in the study included:

  • 21.8 percent were in debt due to treatment-related expenses with an average debt of $26,860.
  • 16.5 percent borrowed money from family or friends, on average $14,144.
  • 5.4 percent either sold their home or took out a second mortgage
  • 23.9 percent had at least a 20 percent drop in household income

Factors that contributed to financial problems were

  • Being younger than 50
  • Nonwhite race
  • Annual income less than $50,000
  • Medicaid or no insurance
  • Work disability, leave of absence, or unemployment

People less likely to have serious financial issues were

  • Widows
  • People insured by Medicare with supplemental insurance
  • Retirees

Veena Shankaran and her colleagues concluded,

A significant proportion of patients undergoing adjuvant chemotherapy for stage III colon cancer may experience financial hardship, despite having health insurance coverage. Interventions to help at-risk patients early on during therapy may prevent long-term financial adverse effects.

They also wrote,

Future research should focus on exploring the impact of various financial experiences on quality of life and identifying specific factors that contribute to financial hardship. Interventions should be developed to help at-risk individuals before they face financial ruin.

Source: Shankaran et al, Journal of Clinical Oncology, Early Release, March 12, 2012.

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