Adult survivors of AYA cancers more likely to experience higher medical financial hardship

Reviewed by Emily Henderson, B.Sc.Apr 12 2021

New study finds higher medical financial hardship in adult survivors of adolescent and young adult (AYA) cancers than in adults without a history of cancer in the United States. The study appears in JNCI: The Journal of the National Cancer Institute.

Experts have known that cancer and its treatment can cause significant financial hardship to cancer survivors and their families. However, the long-term economic implications for adult survivors of AYA cancers were not fully understood. In this study, investigators led by Amy D. Lu, MD, The Hospital for Sick Children, and Zhiyuan "Jason" Zheng, Ph.D., American Cancer Society, used data from the National Health Interview Survey (2010-2018) and analyzed responses from adult (>18 years) survivors of AYA cancers (ages 15-39 at diagnosis) and adults without a cancer history. The study explored the various aspects of financial hardships including material (for example, ability to pay bills), psychological (for example, worries about medical bills), and behavioral (for example, delaying or foregoing medical care) measures.

Key study findings include:

• Adult survivors of AYA cancers were more likely than adults without a cancer history, to report material and behavioral financial hardship, including problems paying medical bills or delaying or forgoing care because of cost.
• Adult survivors of AYA cancers were more likely to report greater intensity of medical financial hardship than their counterparts without a cancer history.
• Adult survivors of AYA cancers were more likely to report cost-related medication non-adherence, such as skipping medication doses, taking less medication, and delaying filling a prescription to save money.

Multiple aspects of financial hardship associated with a cancer diagnosis may last for many years for survivors of AYA cancers."

Dr. Zhiyuan "Jason" Zheng, Ph.D., American Cancer Society

As the incidences of AYA cancers increases, understanding the spectrum of medical financial hardship is critical to those caring for and designing policies for adult survivors of AYA cancers, and in guiding ongoing research in this area.

"Healthcare providers can help support increased awareness and assessment of financial hardship, as well as subsequent connection to existing financial and vocational assistance/support services. State and federal policies may have a broader impact through implementation of provisions of the Affordable Care Act in increasing insurance coverage options including affordability and accessibility," said the authors.