Paying for daily living necessities such as food, housing, and other monthly bills puts a more significant strain on younger cancer survivors, even years after their diagnosis, according to findings published in the March 2020 issue of the Journal of the National Comprehensive Cancer Network.1 Among survivors of cancer who are aged 18 to 39 years, the study found that approximately 20.4% expressed high levels of worry about paying their monthly bills compared with 12.9% of individuals who did not have a history of cancer. Furthermore, approximately 6.3% of survivors in that same age group noted that they were unable to afford balanced meals compared with 3.4% of respondents without a cancer history. Older survivors aged 40 to 64 years reported less consistent findings, and the disparities were not noted to be present among participants aged 65 years and older. According to the study's lead researcher Zhiyuan “Jason” Zheng, PhD, a health economist and principal scientist in the Surveillance and Health Services Research program at the American Cancer Society, in Atlanta, Georgia, one possible reason for the disparity could be that younger cancer survivors' health conditions may cause them to lose their jobs and health insurance coverage. Child-rearing demands, mortgage obligations, student loans, low rates of savings, and significantly increasing costs of cancer care likely compound the problem further, he adds. Dr. Zheng and his colleagues used the 2013 to 2017 National Health Interview Survey, a cross-sectional household survey from the Centers for Disease Control and Prevention. It included more than 12,000 cancer survivors, excluding survivors of nonmelanoma skin cancer, who were aged 18 to 65 years and older. Financial concerns were sorted into categories related to retirement, the standard of living, monthly bills, and housing costs. The investigators assigned a point system based on concerns ranging from “very worried” to “not worried at all.” The analysis found that approximately 26.4% of cancer survivors aged 18 to 39 years reported severe financial worry, whereas 12.6% reported severe food insecurity. The results among survivors aged 40 to 64 years demonstrated approximately 22.2% reporting severe financial worry compared with 6.8% reporting severe food insecurity. In the survivor cohort aged 65 years and older, approximately 6.9% reported severe financial worry whereas 2.3% reported severe food insecurity. Dr. Zheng emphasizes the importance of addressing the needs of younger, low-income cancer survivors with higher numbers of comorbid conditions through clinical and health policy interventions that help to minimize their financial burdens and food insecurity. He points to promising developments, such as The Deferment for Active Cancer Treatment Act, passed by Congress in 2018, which allows patients with cancer to postpone payments on public student loans while they are actively receiving cancer treatment. At the same time, the Centers for Medicare and Medicaid Services has expanded coverage for young people with disabilities to include healthy groceries, rides to medical appointments, and home-delivered meals. The authors call for future research evaluating the impact of various financial hardships on outcomes among long-term cancer survivors.
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Mar 18, 2021
By Kristen Morgan 
Open Access