Over a million U.S. cancer survivors foregoing vital treatments due to costs

Feb 5 2009

More than a million cancer survivors living in the United States are foregoing what they believe is necessary medical care due to the cost, and Hispanics and African-Americans are twice as likely to go without services, according to data presented at the American Association for Cancer Research conference on the Science of Health Care Disparities.

"These survivors are either going without, or significantly delaying, dental care, general medical care, mental health care or prescription drugs," said Kathryn Weaver, Ph.D., a cancer prevention fellow at the National Cancer Institute.

Although insurance status did play a role, foregoing care due to cost still persisted among the insured. "There are significant out-of-pocket expenses, even for those with insurance," said Weaver.

Weaver and colleagues used data from the Center for Disease Control's National Health Interview Survey to identify 6,602 adult cancer survivors. Of these survivors, 64.3 percent were female, 4.8 percent were Hispanic, 6.4 percent were non-Hispanic black and 88.8 percent were non-Hispanic white. The survey is conducted annually and questions about 30,000 to 40,000 households.

Overall, the prevalence of foregoing medical care due to cost was 7.8 percent for general medical care, 9.9 percent for prescription medication, 11.3 percent for dental care and 2.7 percent for mental health care.

Compared to non-Hispanic whites, Hispanics were 2.14-fold more likely to forego prescription medications due to cost concerns and African-Americans were 87 percent more likely to forego prescriptions. For dental care, Hispanics were 2.31-fold more likely to go without and African-Americans were 57 percent more likely.

These differences persisted after statistical adjustments for education, health insurance coverage and non-cancer medical comorbidities.

"Efforts to expand insurance coverage might go some way toward addressing these problems, but absent that, clinicians need to be more aware that their patients are not getting these services and work to try to connect them to charity or low-cost care," said Weaver.