Financial burden higher in patients treated for colorectal cancer

Nearly two-thirds of patients treated for colorectal cancer reported some measure of financial burden due to their treatment, according to a new study from researchers at the University of Michigan Comprehensive Cancer Center.

The burden was greatest among patients who received chemotherapy and among younger patients who worked in low-paying jobs.

The study surveyed 956 patients who had been treated for stage 3 colorectal cancer. Among this group, chemotherapy is known to increase survival by up to 20 percent and is routinely recommended following surgery.

"The financial burden was higher in patients who received chemotherapy – a potentially lifesaving treatment. To ensure that patients can receive all recommended care, we need to recognize the financial burden of cancer and identify patients at risk for financial concerns," says lead study author Christine M. Veenstra, M.D., M.S.H.P., clinical lecturer in hematology/oncology at the University of Michigan Medical School.

"We found that younger, working low-income patients were especially likely to face financial burden. These are people who may not be able to afford to take time off from their jobs to get recommended cancer care, including chemotherapy," Veenstra adds.

Patients were identified through the Surveillance, Epidemiology and End Results cancer registries for the Metro Detroit area and the state of Georgia. Patients were asked to answer a seven-question survey that asked whether they had used savings, borrowed money, skipped bill payments or cut back on items such as food, clothing or recreational activities because of their cancer treatment.

Overall, 38 percent did not indicate financial burden based on the seven questions. Of the remaining 62 percent:

• 29 percent indicated 1-2 areas of burden
• 23 percent indicated 3-4 areas of burden
• 9 percent indicated 5 or more burdens

Nearly half of patients noted that they cut down on expenses in general because of their cancer treatment. Patients who had chemotherapy were significantly more likely to select each item of financial burden. Results of the study appear in the journal Medical Care.

"It's important to note that this financial burden is experienced on top of all that patients are going through with the cancer itself. The financial burden hits hard," says senior study author Arden M. Morris, M.D., M.P.H., chief of colorectal surgery at the University of Michigan Medical School and associate professor of health behavior and health education at the School of Public Health.

The researchers urge policy changes to job support measures such as mandatory paid sick leave or disability benefits. They also recommend support for copays, parking and transportation.

In addition, patients should speak to their doctor about financial concerns, and doctors should be aware of the financial burden on patients.

"It's important to start the dialog between patients and doctors. Some financial supports currently exist that may benefit patients if they're aware. It may not be enough to fully cover their financial burden, but it could help," says Morris, who is also a member of the University of Michigan Center for Healthcare Outcomes and Policy and the Cancer Surveillance and Outcomes Research Team.